广西医学2011，Vol.33Issue(10)：1258-1262,5.
同期化疗并后程加速超分割适形放疗食管癌的临床研究
Clinical Study of a Combination Regimen with Late Course Accelerated Hyperfractionated Comformal Radiotherapy and Concurrent Chemotherapy in Esophageal Carcinoma
摘要
Abstract
Objective To analyze the curative effect , tolerance and toxic side effects of late course accelerated hyperfractionation three-dimensional conformal radiotherapy( LCAH-3DCRT )combined with concurrent chemotherapy in patients with esophageal carcinoma. Methods Eighty patients with advance esophageal squamous cell were divided randomly into two groups :conventional radio-chemotherapy group( CRC group )and LCAH group, all of this patients didn't have distant metastasis and it's lesion extent were less than or equal to 12 cm. Patients in both groups were given 2 cycle chemotherapy before irradiation and 3 to 4 weeks after initiation of irradiation , respectively. The regimen was as follows : DDP 30 mg/m2 at day 1 to day 3,5-Fu 500 mg/m2 at day 1 to day 5,calcium folinate 0.2 ml at day 1 to day 5. Patients in CRC group were treated with conventional fractionation radiotherapy to a dose of 40 Gy,followed by a total dose of 64 -70 Gy by reduced radiation field in 30 - 36 fractions over 35 - 45 days. Patients in LCAH group were initiated with a conventional irradiation to a dose about 30 - 36 Gy, which was then followed by accelerated hyperfractionation irradiation , twice daily at 1. 5 Gy per fraction with a dose about 34 - 36 Gy,resulting in a total dose about 66 - 70 Gy over 35 -42 days. Results The 1 - ,2 - ,3 - ,4 - year overall survival was 69. 5％ ,55. 8％ ,43. 7％ ,38. 9％ respectively for LCAH group , while in CRC group were 55. 0％,39. 7％,28. 4％,22. 1％, respectively , the difference was significant( P＜0. 05 ). The 1 -, 2 - ,3 - ,4 - year local control rate were 72. 0％ ,62. 6％,59. 1％,55. 2％ respectively for LCAH group , while in CRC group were 64. 6％,50. 5％,47. 1％,39. 4％, respectively , the difference was not significant( P＞0. 05 ). The rate of Ⅲ-Ⅳ esophagitis in LCAH group was higher than that in CRC group( P＜0. 01 ). The difference of occurrences of the radiation-induced acute bronchitis,leukocyte decrease and pulmonary fibrosis were not statistical significant( P＞0. 05 ).Conclusion Combination of LCAH-3DCRT and concurrent chemotherapy can improve overall survival of esophageal carcinoma,but may increase the risk of Ⅲ - Ⅳ esophagitis.关键词
食管肿瘤/放射疗法/后程加速超分割/毒副作用Key words
Esophageal carcinoma/Radiotherapy/Late course accelerated hyperfractionated comformal radiotherapy/Toxic side effects分类
医药卫生引用本文复制引用
蔡凯,胡联民,刘俊波,黄常江,陈刚,廖天华,莫春明..同期化疗并后程加速超分割适形放疗食管癌的临床研究[J].广西医学,2011,33(10):1258-1262,5.基金项目
广西贵港市科学研究与技术开发计划项目(0504002) （0504002）
