李晓敏, 章荣棻, 郭丹, 王静怡, 王鹤皋. 食管癌后程加速超分割放射治疗的临床疗效分析[J]. 中国肿瘤临床, 2006, 33(18): 1025-1028.
引用本文: 李晓敏, 章荣棻, 郭丹, 王静怡, 王鹤皋. 食管癌后程加速超分割放射治疗的临床疗效分析[J]. 中国肿瘤临床, 2006, 33(18): 1025-1028.
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Li Xiaomin, Zhang Rongfen, Guo Dan, . Clinical Analysis for Effect of Late-Course Accelerated Hyperfractionation for Esophageal Carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2006, 33(18): 1025-1028.
Citation: Li Xiaomin, Zhang Rongfen, Guo Dan, . Clinical Analysis for Effect of Late-Course Accelerated Hyperfractionation for Esophageal Carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2006, 33(18): 1025-1028.
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食管癌后程加速超分割放射治疗的临床疗效分析

Clinical Analysis for Effect of Late-Course Accelerated Hyperfractionation for Esophageal Carcinoma

    摘要
  • 摘要: 目的 :比较单纯后程加速超分割及在后程加速超分割基础上协同化疗与常规分割放射治疗食管癌的疗效与不良反应。从而为食管癌的治疗提供一个疗效确切的方案。 方法 :将150例符合条件的胸段食管鳞癌患者随机分成3组;1)常规分割组(CF)为5次/周,2.0Gy/次,总量60Gy;2)后程加速超分割组(LCAHF)则先常规照射30Gy3周后改2次/d,1.5Gy/次,间隔≥6h,加量至60Gy;3)后程加速超分割协同化疗组(LCAHF+C),在LCAHF的同期加用顺铂20mg,氟脲嘧啶500mg,1次/周,共5个周期。 结果 :CF组1、2、3、4、5、6年生存率为54%、30%、18%、18%、12%、10%,LCAHF组为76%、56%、44%、42%、34%、30%,LCAHF+C组为82%、62%、50%、44%、38%、34%;1、2、3、4、5、6年局部控制率分别为CF组40%、32%、26%、24%、22%、16%,LCAHF组为72%、60%、56%、54%、48%、42%,LC-AHF+C组78%、66%、60%、56%、50%、46%。LCAHF和LCAHF+C两组局控率均明显高于CF组(P<0.01),LCAHF与LCAHF+C组间差异无显著性意义(P<0.05)。急性不良反应LCAHF+C组较CF组严重,LCAHF组介于两者之间。3组的晚期并发症及死亡原因无明显差异,而LCAHF和LCAHF+C组死于局部未控或复发的明显低于常规组。 结论 :LCAHF与LCAHF+C组均能显著提高食管癌的局部控制率与生存率,但后者因不良反应增加,未体现出其更加突出的优越性。

     

    Abstract: Objective :To compare the curative and adverse effect between the late-course accelerated hyperfractionation(LCAHF),LCAF plus synergistic chemotherapy(LCAHF+C)and conventional fractionation(CF)on esophageal cancer. Methods :A total of 150 patients with squamous carcinoma of thoracic esophagus were randomly divided into three groups,i.e.,a)the CF group:the patients were given irradiation at 2.0 Gy/f,5 times a week,up to a total dose of 60 Gy;b)the LCAHF group:the patients were first irradiated with CF to 30 Gy,then followed by 1.5 Gy/f b.i.d.,at an interval of more than 6 hours,till a total dose of 60 Gy and c)the LCAHF+C group:the radiotherapy technique was the same as the LCAHF group,but a dose of weekly 20mg DDP and 500mg 5-Fu were added simultaneously for 5 weeks. Results :All the groups completed their treatment course.The 1-,2-,3-,4-,5-and 6-year survival rates in the three groups was 54%,30%,18%,18%,12% and 10% in CF group,76%,56%,44%,42%,34% and 30% in LCAHF group and 82%,62%,50%,44%,38% and 34%,respectively.The 1-,2-,3-,4-,5-and 6-year local control rates in the three groups was 40%,32%,26%,24%,22% and 16% in CF group,72%,60%,56%,54%,48% and 42% in LCAHF group and 78%,66%,60%,56%,50% and 46% in LCAHF+C group,respectively.There was an obvious better Results in the latter two groups(P<0.01)compared to the first one,though no any statistical difference was found between the latter two groups(P<0.05).The acute toxic effect was severer in the LCAHF+C group than in the other two,with the difference significant between the LCAHF+C and CF group,but not between the LCAHF and CF group.The tolerance of the patients in the LCAHF group was better than in the LCAHF+C group.There was no significant difference in late complications and cause of death between the three groups.The main cause of death was local recurrence and uncontrolled primary disease,which were significantly lower in the LCAHF and LCAHF+C groups than in the CF group. Conclusion s:Both late-course accelerated hyperfractionation(LCAHF)and LCAHF radiotherapy plus chemotherapy can significantly improve the local control and survival rate of esophageal cancer,but the toxicity has increased in the latter.It did not showed more beneficence.

     

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