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目的探讨不均等加速放疗配合甲氨蝶呤增敏治疗食管鳞癌的治疗效果。方法回顾分析48例确诊为食管鳞癌患者的随访资料。放疗方案:先设前后野照射DT40~44Gy,后改为等中心照射缩野躲开脊髓加量24~28Gy,具体分割方法为:周一至周五上午,常规分割剂量(2Gy)1次/d;周一、三、五下午,与上午放疗间隔>6h,分割剂量1.5Gy。化疗方案:每周2次静脉推注甲氨蝶呤50mg,共3周。结果1、3、5年的局部控制率和生存率分别为:80.8%、54.9%、39.6%和71%、42.6%、30.7%。结论不均等加速放疗配合甲氨蝶呤增敏治疗食管鳞癌的治疗方法是可行的。
Objective To investigate the treatment of esophageal squamous cell carcinoma (ESCC) with accelerated radiotherapy combined with methotrexate. Methods Retrospective analysis of 48 cases of esophageal squamous cell carcinoma patients were followed up. Radiotherapy options: the first set before and after the field irradiation DT40 ~ 44Gy, after the center instead of shrinking to avoid the spinal cord to increase the dose of 24 ~ 28Gy, the specific method for the segmentation: Monday to Friday morning, the conventional fractionation dose (2Gy) 1 / d ; Monday, Wednesday and Friday afternoon, and morning radiotherapy interval> 6h, split dose 1.5Gy. Chemotherapy regimen: Intravenous injection of methotrexate 50 mg twice weekly for 3 weeks. Results The local control rates and survival rates at 1, 3 and 5 years were 80.8%, 54.9%, 39.6% and 71%, 42.6% and 30.7% respectively. Conclusions Unequal accelerated radiotherapy combined with methotrexate hypersensitivity in the treatment of esophageal squamous cell carcinoma is feasible.