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目的 评价大野套小野加速超分割与常规分割放射治疗上段食管癌的疗效及预防照射双锁骨上淋巴结的意义。方法 将 76例上段食管癌分为 2个组。常规 (CF)组 37例前大野后 2个野等中心同时照射 ,2 .0Gy/次 ,1次 /d ,5次 /周 ;照射至 40～ 45Gy后缩野照射 ,总剂量达DT6 0～ 6 6Gy ,锁骨上预防照射DT45Gy,总疗程 6～ 7周。超分割 (AF)组 39例 ,1.0～ 1.5Gy/次 ,2次 /d ,间隔 6h ,10次 /周 ;前大野总剂量DT40～ 45Gy,2个后小野等中心照射总剂量DT2 0～ 2 5Gy。结果 完全缓解 (CR)率和总有效 (CR +PR)率AF组分别为 71.8%和 97.4% ;CF组分别为 5 4.1%和 91.9%。 2个组生存率曲线比较差异有显著性意义 (χ2 =5 .6 70 ,P =0 .0 2 5 )。AF组 1、2、3年生存率分别为 82 .0 %、6 1.5 %、48.7% ,CF组分别为 6 4.8%、48.6 %、37.8%。AF组 1、2、3年局部控制率分别为 79.4%、5 3.8%、46 .1% ,CF组分别为 5 6 .7%、45 .9%、37.8%。 2个组 1年局部控制率比较差异有显著性意义 (χ2 =4.5 40 ,P =0 .0 33)。结论 大野套小野加速超分割放射治疗上段食管癌疗效优于常规分割法。
OBJECTIVE To evaluate the curative effect of Ohno Ono accelerated hyperfractionation and conventional segmental radiotherapy in upper esophageal cancer and to prevent the irradiation of double supraclavicular lymph nodes. Methods 76 cases of upper esophageal cancer were divided into two groups. In the routine group (CF group), two wild centers were exposed to 2 Gy, 2 Gy, 1 time / d, 5 times / 6 6Gy, supraclavicular prophylaxis DT45Gy, the total course of 6 to 7 weeks. The patients in AF group had 39 patients with 1.0 ~ 1.5Gy / time, 2 times / d, 6h intervals and 10 times / week. The former total dose of DT40 ~ 45Gy, 5Gy. Results The rates of complete remission (CR) and total effective (CR + PR) were 71.8% and 97.4% in the AF group and 5 4.1% and 91.9% in the CF group, respectively. There was significant difference in survival rate between the two groups (χ2 = 5.66, P = .025). The 1-year, 2-year and 3-year survival rates in AF group were 82.0%, 61.5%, 48.7%, respectively, and those in CF group were 6 4.8%, 48.6% and 37.8%, respectively. The local control rates at 1, 2, and 3 years in AF group were 79.4%, 53.8% and 46.1% respectively, while those in CF group were 56.7%, 45.9% and 37.8% respectively. There was a significant difference in the local control rate between the two groups in one year (χ2 = 4.540, P = 0.033). Conclusion Ohno Mitsuhiro Ono accelerated superfractionated radiotherapy of upper esophageal cancer curative effect is superior to conventional segmentation.