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目的 比较连续加速超分割 (CAHF)和后程加速超分割 (LCAF)放射治疗食管癌的疗效和毒性。方法 10 1例食管鳞癌患者前瞻性随机分成 2个组。LCAF组 (5 2例 )前 2 3疗程为常规分割(5次 周 ,1.8Gy 次 ) ,照射 41.4Gy后缩野改加速超分割 (2次 d ,1.5Gy 次 )照射 2 7Gy ,总量 6 8.4Gy ,41次 ,44～ 46d ,CAHF组 (4 9例 )从治疗开始 ,2次 d ,1.5Gy 次 ,照射至 39Gy后缩野继续原分割方案照射 ,总量 6 6Gy,44次 ,30～ 32d。结果 LCAF组所有病例均完成疗程 ,CAHF组 1例因难以耐受放射性食管炎而终止治疗。LCAF组Ⅰ、Ⅱ、Ⅲ度急性放射性气管炎发生率分别为 13 .5 %、2 1.2 %、3.8%;CAHF组分别为 18.4%、30 .6 %、8.2 %。 2个组差异无显著性意义 (χ2 =3 .72 9,P =0 .2 92 )。LCAF组Ⅰ、Ⅱ、Ⅲ、Ⅳ度急性放射性食管炎发生率分别为 2 6 .9%、32 .7%、7.7%、1.9%;CAHF组分别为 6 .1%、32 .7%、46 .9%、14.3%。 2个组差异有显著性意义 (χ2 =40 .95 2 ,P <0 .0 0 1)。用Kaplan Meier法计算的1、2、3生存率LCAF组为 80 .0 %、5 7.6 %、41.2 %,CAHF组为 79.6 %、5 1.6 %、37.6 %(χ2 =0 .31,P =0 .5 75 7)。 1、2、3年局部控制率 :LCAF组为 80 .7%、71.4%、5 7.1%,CAHF组为 88.7%、79.5 %、5 2 .9%(χ2 =2 .35 0 ,P
Objective To compare the efficacy and toxicity of continuous accelerated hyperfractionation (CAHF) and late-course accelerated hyperfractionation (LCAF) in the treatment of esophageal cancer. Methods 101 patients with esophageal squamous cell carcinoma were randomly divided into two groups. In the LCAF group (52 cases), the first 2 3 treatments were routinely divided (5 weeks, 1.8 Gy), irradiated with 41.4 Gy, followed by shrinkage and accelerated hyperfractionation (2 times d, 1.5 Gy) irradiation, 27 Gy, total 6 At 8.4 Gy, 41 and 44 to 46 days, the CAHF group (49 cases) started from the treatment, twice d, and 1.5 Gy times. After irradiation to 39 Gy, the contraction was continued with the original segmentation scheme. The total amount was 6 6 Gy, 44 times. ~ 32d. Results All patients in the LCAF group completed the course of treatment. One patient in the CAHF group was discontinued because of the difficulty in tolerating radiation esophagitis. The incidence of acute radiotracheitis I, II, and III in LCAF group was 13.5%, 21.2%, and 3.8%, respectively; in CAHF group, they were 18.4%, 30.6%, and 8.2%, respectively. There was no significant difference between the two groups (χ2 =3.72 9,P =0.292). The incidence of acute radiation esophagitis in LCAF group I, II, III and IV degrees was 26.9%, 32.7%, 7.7%, and 1.9%, respectively; in the CAHF group, they were 6.1%, 32.7%, and 46, respectively. .9%, 14.3%. There was a significant difference between the two groups (χ2 = 40.95 2 , P <0.01). The 1, 2, and 3 survival rates calculated by the Kaplan Meier method were 80.0%, 5.6%, and 41.2% in the LCAF group, and 79.6%, 5.16%, and 37.6% in the CAHF group (χ2=0.31, P=0). .5 75 7). The local control rates in the 1st, 2nd and 3rd years were 80.7%, 71.4%, and 5 7.1% in the LCAF group, and 88.7%, 79.5 %, and 52.9% in the CAHF group (χ2 = 2.35 0 ,P).