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目的 :评价化疗加后程加速超分割放射治疗食管癌的疗效。方法 :118例食管癌患者 ,随机分为 2组 (化放组与单放组 ) ,每组 5 9例。放疗采用 6MVX线外照射 ,前 2 / 3疗程常规放射治疗 2Gy/次 ,共 4 0Gy ;后 1/ 3疗程改用加速超分割放射治疗 (2次 /天 ,1 35～ 1 4Gy/次 ) ,全疗程总剂量共 6 7～ 6 8Gy ,4 0分次 ,4 0～ 4 2天完成 ;化疗采用FP方案 (5 氟脲嘧啶和顺铂 )。结果 :化放组与单放组的 1、2年生存率分别为 86 4 %、6 9 5 %和 72 9%、5 0 8% (χ2 =3 95 ,4 2 8,P <0 0 5 ) ,其中 3、4年生存率分别为 4 9 2 %、4 2 4 %和 4 0 7%、33 9% (χ2 =0 86 ,0 89,P >0 0 5 )。结论 :化疗加后程加速超分割放射治疗食管癌能提高患者的近期生存率 ,并未增加毒性反应。
OBJECTIVE: To evaluate the efficacy of chemotherapy plus late-course hyperfractionated radiation in the treatment of esophageal cancer. Methods: A total of 118 patients with esophageal cancer were randomly divided into 2 groups (59 cases in each group). Radiotherapy with 6MVX line outside the former 2/3 course of conventional radiotherapy 2Gy / times, a total of 40Gy; 1/3 course of treatment switched to accelerated hyperfractionation radiotherapy (2 times / day, 1 35 ~ 1 4Gy / time) The total dose of a total of 6 7 ~ 6 8Gy, 40 times, 40 ~ 42 days to complete; chemotherapy using FP regimen (5-fluorouracil and cisplatin). Results The 1-year and 2-year survival rates were 86 4%, 69 5%, 72 9% and 58 0% (χ2 = 3 95, 428, P <0.05) ). The 3-year and 4-year survival rates were 49.2%, 42.4% and 40.7%, 33.9%, respectively (χ2 = 0 86, 0 89, P 0 05). Conclusions: Chemotherapy plus late accelerated hyperfractionated radiotherapy for esophageal cancer can improve the short-term survival of patients without increasing toxicity.