论文部分内容阅读
目的比较常规分割、后程加速超分割及全程加速超分割放疗胸中下段食管中分化鳞癌的疗效与副反应。方法将90例患者随机分成3个组：(1)常规分割(CF)组,2．0Gy/次,1次/d,5d/周,总量70Gy；(2)后程加速超分割(LCAF)组,先常规分割放疗40Gy,后1．5Gy/次,2次/d,间隔>6h,5d/周,加量至70Gy；(3)全程加速超分割(WCAHF)组,1．5Gy/次,2次/d,间隔＞6h,5d/周,总量至72Gy。结果CF和LCAF及WCAHF组1、2、3年局部控制率分别为47%、17%、0%和60%、20%、20%及60%、40%、33%,WCAHF组局部控制率明显高于CF、LCAF组(P＜0．01)。CF和LCAF及WCAHF组1、2、3年生存率分别为47%、20%、10%和63%、43%、17%及63%、50%、33%。WCAHF、LCAF组的2、3年生存率明显高于CF组(P＜0．01)。急性副反应WCAHF、LCAF组较CF组严重,WCAHF和LCAF组急性放射性食管炎2～3级明显高于CF组,但晚期放射性食管炎3个组无差异。WCAHF组1～2级急性放射性肺炎高于LCAF、CF组,且WCAHF组1例因放射性肺炎而导致死亡。结论WCAHF组能提高食管癌的局部控制率和2、3年生存率,但副反应稍有增加。
Objective To compare the curative effect and side effects of routinely divided, late-accelerated and ultra-fractionated radiosurgery in the treatment of middle and lower esophageal squamous cell carcinoma. Methods Ninety patients were randomly divided into three groups: (1) conventional fractionation (CF) group, 2.0Gy / time, once / d, 5d / week, total 70Gy; (2) ) Group, the conventional radiotherapy 40Gy, after 1.5Gy / times, 2 times / d, interval> 6h, 5d / week, add to 70Gy; (3) the whole accelerated hyperfractionation (WCAHF) Times, 2 times / d, interval> 6h, 5d / week, the total amount to 72Gy. Results The local control rates at 1, 2 and 3 years in CF, LCAF and WCAHF groups were 47%, 17%, 0% and 60%, 20%, 20% and 60%, 40% and 33% Significantly higher than CF, LCAF group (P <0.01). The 1, 2, 3-year survival rates of CF, LCAF and WCAHF were 47%, 20%, 10% and 63%, 43%, 17% and 63%, 50% and 33%, respectively. The 2 and 3-year survival rates of WCAHF and LCAF groups were significantly higher than those of CF group (P <0.01). Acute adverse reactions WCAHF, LCAF group was more serious than CF group, WCAHF and LCAF group acute esophagitis 2 to 3 was significantly higher than the CF group, but the late radiation esophagitis 3 groups no difference. Grade 1 or 2 acute radiation pneumonitis in WCAHF group was higher than that in LCAF and CF group, and 1 case died of radiation pneumonitis in WCAHF group. Conclusion WCAHF group can improve the local control rate of esophageal cancer and 2, 3-year survival rate, but a slight increase in side effects.