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目的观察后程加速超分割放疗同期单药顺铂化疗对食管癌的放射增效作用。方法将符合入选条件的104例食管鳞状细胞癌患者随机分为后程加速超分割放疗组(简称单放组,53例)和后程加速超分割放射加顺铂组(简称放化组,51例)。放疗方法2个组相同,前3周为常规放疗(2 Gy/次,1次/d,5 d/周),后2周改为加速超分割放疗(1.5 Gy/次,2次/d,间隔6 h或以上,5 d/周)。顺铂于放疗第1、5周分别给予20 mg/d,连续5 d。结果单放组和放化组的中位生存期分别为12.2、17.0个月。单放组1、3年生存率分别为52.8%、20.8%,放化组的分别为58.0%、24.0%(P>0.05)。放化组的胃肠道及血液方面的急性反应较明显,而急性食管炎及晚期副反应无明显增加。结论后程加速超分割放射加顺铂治疗食管癌较单纯后程加速超分割放疗有提高总生存率的趋势。
Objective To observe the radiosensitization effect of late course accelerated hyperfraction radiotherapy on esophageal cancer with cisplatin alone. Methods A total of 104 patients with esophageal squamous cell carcinoma who met the inclusion criteria were randomly divided into late accelerated hyperfractionation radiotherapy group (53 cases) and late accelerated hyperfractionated radiotherapy plus cisplatin group (abbreviated as radiotherapy group, 51 cases). Radiotherapy methods were the same in the two groups. Conventional radiotherapy (2 Gy / time, 1 time / d, 5 days / week) was performed in the first 3 weeks and accelerated hyperfraction radiotherapy (1.5 Gy / time, Interval 6 h or more, 5 d / week). Cisplatin given in the first week after radiotherapy, 20 mg / d for 5 days. Results The median survival time of radiotherapy alone group and radiotherapy group were 12.2 and 17.0 months respectively. The 1-year and 3-year survival rates were 52.8% and 20.8% respectively in radiotherapy group and 58.0% and 24.0% in radiotherapy group (P> 0.05). Radiotherapy group of gastrointestinal and blood more acute response, and acute esophagitis and no significant increase in late side effects. Conclusions Accelerated hyperfractionation plus cisplatin in the treatment of esophageal cancer has the tendency to increase the overall survival rate as compared with the simple subsequent accelerated hyperfractionation radiotherapy.