摘要
目的 评价后程超分割放射治疗食管癌的疗效及放射反应。方法 对 96例食管癌随机分为后程超分割组 (后超组 )和常规组 ,每组 48例。经病理证实 76例 ,后超组 39例 ,常规组 37例 ,均为鳞癌。男性 6 5例 ,女性 31例。年龄 41～ 70岁 ,中位年龄 5 7.1岁。病变部位 :胸上段 2 1例 ,胸中段 6 3例 ,胸下段 12例。病变长度 :<5 .0cm 2 9例 ,5 .0～ 7.0cm 5 7例 ,>7.0cm 10例。全部采用60 Co外照射 ,常规组 1次 d ,2 .0Gy 次 ,5次 周 ,总剂量 6 4Gy,32分次 ,44d完成。后超组放射治疗前 2 3疗程同常规组 ,照射到 40Gy后改为 1.15～ 1.2 5Gy 次 ,2次 d ,间隔 6～ 8h ,使总剂量达到 6 8～ 70Gy ,44～45d完成。结果 随访率为 96 .9%。 1、3、5年生存率后超组为 81.1%、44 .1%、2 6 .8% ,常规组为 6 1.7%、2 5 .1%、16 .9%。后超组 1、3年生存率高于常规组 (u值为 2 .97及 2 .6 4,P <0 .0 1) ,5年生存率无显著性意义 (u =1.71,P >0 .0 5 )。后超组和常规组放射性食管炎的发生率分别为 2 7.1%及 16 .7%(χ2 =1.5 2 ,P =0 .2 0 ) ;放射性支气管炎的发生率后超组为 18.8% ,常规组为 12 .5 % (χ2 =0 .71,P =0 .40 )。结论 食管癌后程超分割治疗 1、3生存率高于常规组 。
Objective To evaluate the effect and the radiation reaction of esophageal cancer patients treated by LCHR.Methods 96 patients of esophageal cancer were treated by LCHR. 76 patients had pathology evidence. There were 65 males and 31 females. The ages ranged from 41 to 70 years with median 57.5 years. The patients with lesion in upper thoracic segment 21 cases, Middle thoracic segment 63 cases, lower thoracic segment 12 cases. The length of lesions: <5.O?cm 29 cases. 5.O～7.O?cm 57 cases. >7.0?cm 10 cases. They were randomly divided into two groups, The conventional radiation group (48 cases). And late course hyperfractionation (48 cases).Both groups were treated by 60Co γ- ray external radiation 2.0?Gy every time each day, five times in each week in conventional group, the total dose 64?Gy/32 fractions/44d; in the late course hyperfractionation group. 40?Gy in four weeks at first and then two times each day with 1.15～1.25?Gy every time and with 6～8 hours, interval, from the fifth week, ten times in each week, ale total dose 68～70?Gy/44～45d. Results All patients were followed at more then five years. The follow-up rate was 96.9%. The survival rate of 1,3,5-year in late course hyperactionation group were 81.1%, 44.1%, 26.8% and 61.7%, 25.1%, 16.9% in conventional group respectively. The survival rate of late course hyperactionation group is better than conventional group. Between the two groups , there was significant difference in the survival rate of 1,3-year (P<0.01), but there was no significant difference in the survival rate of 5-year (P>0.05). Conclusions The result showed that the 1,3,5-year survival rate of LCHR of esophageal cancer is better than conventional radiotherapy. Between the two groups , there was significant difference in the survival rate of 1,3-year ,However there is no significant difference in the survival rate of 5-year. It is well tolerated, without late reactions in long term survivors.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2001年第4期236-238,共3页
Chinese Journal of Radiation Oncology
关键词
食管肿瘤
放射治疗
后程超分割
预后
Esophageal neoplasms/radiotherapy
Late course hyperfractionation
Prognosis
