| 陈俊强,陈明强,李云英,潘建基,邵凌东.化疗并后程加速超分割放疗中晚期食管癌[J].中华放射医学与防护杂志,2003,23(5):343-345 |
| 化疗并后程加速超分割放疗中晚期食管癌 |
| Concurent chemotherapy combined with late course accelerated hyperfractionated radiotherapy for advanced esophageal carcinoma |
| 投稿时间：2003-03-03 |
| DOI： |
| 中文关键词: 食管肿瘤 放射疗法 药物疗法 后程加速超分割 毒副作用 |
| 英文关键词:Esophageal neoplasm Radiotherapy Chemotherapy Late accelerated hyperfractional radiotherapy Toxicity of treatment |
| 基金项目: |
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| 中文摘要: |
| 目的 观察同期化疗并后程加速超分割放疗(后超组)和同期化疗并常规分割放疗治疗食管癌(常规组)的疗效和毒性,寻找更有效的局部控制率和降低远处转移率并提高生存率的治疗方法。方法 选择病变长度≤12cm、无远处转移证据的中晚期食管癌分后超组和常规组各40例。两组化疗方案相同。后超组放疗第1～28天,为常规分割放疗,缩野后行加速超分割放疗,总剂量为67Gy/38次,共42d。常规组放疗为全程常规分割放疗,总剂量为70Gy/35次,共49d。结果 近期疗效后超组:Ⅰ+Ⅱ级31例占775%,Ⅲ+Ⅳ级9例占22.5%,常规组:Ⅰ+Ⅱ级22例占55.0%,Ⅲ+Ⅳ级18例占45.0%(P<0.05)。后超组和常规组1,2年局部控制率分别为77.14%、51.86%和55.21%、31.28%(P=0.049);后超组和常规组1,2年生存率分别为72.22%、48.64%和54.09%、27.33%(P=0.041)。急性放射性食管炎后超组明显重于常规组,且持续时间长。白细胞下降、胃肠道不良反应及放射性肺炎两组比较,其差异无显著性(P>0.05)。结论 (1)同期化疗并后程加速超分割放疗的放射性食管炎虽有所增加,但多数患者能耐受;(2)同期化疗并后程加速超分割放疗较同期化疗并常规分割放射治疗提高了近期疗效、局控率及生存率。 |
| 英文摘要: |
| Objective In order to explore a more effective treatment regiment to improve the local control and the survival rate while reducing distant metastases.This study was aimed to evaluate the effect and toxicity of late accelerated hyperfractionated radiotherapy(LAHF)versus conventional radiotherapy(CF)for patients with advanced esophageal carcinoma.Both groups received concomitant chemotherapy. Methods Eighty patients with advanced esophageal squamous cell carcinoma were included.The eligible criteria included the tumor mass being less than 12 cm in length,and without distant metastases.The patients were randomized into LAHF and CF group.The general conditions of the patients of these two groups did not have statistical significant difference.For the CF group,70 Gy were given in 35 fractions over 49 days,whereas for the LAHF group,radiotherapy was divided into two phases:40 Gy in the first phase with fraction dose 2 Gy per day,27 Gy were given during the second phase with 1.5 Gy per fraction and two fractions a day.The total dose in LAHF group was 67 Gy in 38 fractions over 42 days.The chemotherapy were delivered concurrently with FUDR 500 mg/m +2 and cisplatin 20 mg/m +2 given twice weekly for 3 weeks. Results Thirty-one cases of 1 to 2 grade (77.5%) and 9 cases of 3 to 4 grade (22.5%)in LAHF group showed short-term effect,which was superior to that 22 cases of 1 to 2 grade (55.0%) and 18 cases of 3 to 4 grade (45.0%) in CF group did (P<0.05).The 1- and 2-year local control rate were 77.14%,51.86% in LAHF group and 55.21%,31.28% in CF group,respectively( P =0.049).The 1- and 2-year survival rate were 72.22%,48.64% in LAHF group and 54.09%,27.33% in CF group,respectively( P =0.041).The acute esophagitis was more severe and lasted longer in LAHF than that in CF group.Leucocytopenia,gastrointestinal tract side-reaction acute pneumonitis, and bone marrow depression induced by radiation were not significant difference between these two groups. Conclusion Combined with concomitant chemotherapy,short-term effect,local control and survival rates in LAHF group were better than that in CF group.The incidence of acute esophageal mucositis was relatively higher in LAHF group,but can be tolerated by most patients. |
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