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目的 :探讨后程加速超分割放疗加腔内微波热疗能否提高食管癌的疗效。方法 :采用前瞻性研究 ,6 0例胸段食管癌随机分为热放组与对照组 ,热放组先外照射 DT4 0 Gy～ 4 4 Gy/ 2 0 f～ 2 2f,然后缩野行后程加速超分割治疗 ,每天 2次 ,每次 1.5 Gy,间隔 4 h～ 6 h,至总剂量 DT6 4 Gy～ 70Gy/ 36 f～ 4 0 f。同时加用腔内微波热疗 ,腔内肿瘤表面温度在 4 3℃～ 4 4℃之间 ,治疗 4 0 m in～ 4 5 m in。每周 (2～ 3)次 ,共 (4～ 6 )次。对照组单纯放疗 ,常规分割 ,DT6 4 Gy～ 70 Gy/ 32 f～ 35 f,共 4 4天～ 4 9天。结果 :治疗结束时有效率 (CR+PR) :治疗组为 10 0 % ,对照组为 96 .7% (P>0 .0 5 ) ;完全缓解率(CR) :热放组为 6 0 % ,对照组为 33.3% (P<0 .0 5 ) ;1年肿瘤的局部控制率 :热放组为 73.3% ,对照组为 36 .7% (P<0 .0 1) ;1年生存率 :热效组为 76 .7% ,对照组为 4 6 .7% (P<0 .0 5 ) ;两组的副作用无统计学差异 (P>0 .0 5 )。结论 :后程加速超分割放疗加腔内微波热疗提高了肿瘤的局部控制率和 1年生存率。
Objective: To investigate whether accelerated posterior hyperfractionated radiotherapy plus intracavitary microwave hyperthermia can improve the efficacy of esophageal cancer. METHODS: Sixty patients with thoracic esophageal cancer were randomly divided into heat-radiating group and control group. The patients in heat-radiating group were treated with DT4 0 Gy ~ 4 4 Gy / 2 0 f ~ 2 2f outside before radiotherapy Accelerated hyperfractionation was performed twice a day for 1.5 Gy at intervals of 4 h to 6 h to a total dose of DT6 4 Gy to 70 Gy / 36 f to 40 f. At the same time with the cavity microwave hyperthermia, the cavity surface tumor temperature between 43 ℃ ~ 44 ℃, the treatment of 4 0 m in ~ 4 5 m in. Weekly (2 ~ 3) times, a total of (4 ~ 6) times. Control group, radiotherapy alone, conventional segmentation, DT6 4 Gy ~ 70 Gy / 32 f ~ 35 f, a total of 44 days to 49 days. Results: The effective rate (CR + PR) at the end of treatment was 100% in the treatment group and 96.7% in the control group (P0.05). The complete remission rate (CR) was 60% , And the control group was 33.3% (P <0.05). The local control rates of 1-year tumors were 73.3% in the radiotherapy group and 36.7% (P <0.01) in the control group, and 1-year survival rate : 76.7% in the thermal effect group and 46.7% in the control group (P <0.05). There was no significant difference in side effects between the two groups (P> 0.05). CONCLUSION: Late-course accelerated hyperfractionation plus intracavitary microwave hyperthermia improves the local control rate and 1-year survival rate of tumors.