| 陈俊强,陈明强,李云英,潘建基,林宇邵,凌东.同期化疗并后程加速超分割放疗食管癌的毒副反应[J].中华放射医学与防护杂志,2005,25(4):356-358 |
| 同期化疗并后程加速超分割放疗食管癌的毒副反应 |
| Toxic reactions after late course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy for esophageal carcinoma |
| 投稿时间：2005-01-18 |
| DOI： |
| 中文关键词: 食管肿瘤 放射疗法 后程加速超分割 毒副作用 |
| 英文关键词:Esophageal carcinoma Radiotherapy Accelerated hyperfractionation Toxic reactions |
| 基金项目: |
|
| 摘要点击次数: 2465 |
| 全文下载次数: 1727 |
| 中文摘要: |
| 目的 观察同期化疗并后程加速超分割放疗食管癌耐受性和毒性反应。方法 选择病变长度≤12cm、无远处转移证据(锁骨上淋巴结转移除外)的中晚期食管癌分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射治疗(常规组)各40例。两组化疗方案相同:顺铂20mgm2、氟脲嘧啶脱氧核苷500mgm2、每周2次,共6次。后超组放疗第1～28天,为常规分割放疗,40Gy,分20次,共28d;第29～42天,缩野后行加速超分割放疗,1.5Gy次,2次d,共27Gy,分18次,共13d,总剂量:67Gy,分38次,共42d。常规组放疗为全程常规分割放疗,总剂量为70Gy,分35次,共49d。结果 急性放射性食管炎的发生率后超组为100%,常规组为87.5%;其中Ⅲ、Ⅳ级食管炎的发生率后超组为35%,明显大于常规组15%(P<0.05),且持续时间长。白细胞下降、胃肠道不良反应、放射性肺炎及肺纤维化两组比较,其差异无统计学意义(P>0.05)。后超组有3例、常规组有1例因Ⅲ级食管炎而使疗程中断,经抗生素和激素等对症治疗后均在7d内恢复放疗。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骨髓抑制、胃肠道反应、放射性肺炎及肺纤维化两组比较差异无统计学意义。 |
| 英文摘要: |
| Objective To assess the toxic reactions after late course accelerated hyperfractionated radiotherapy(LAHF) plus concurrent chemotherapy for esophageal carcinoma. Methods Altogether 80 patients with advanced esophageal squamous carcinoma were selected for this study. Eligible criteria included the patients with lesion less than 12 cm in length, without distant metastases. Patients were equally randomized into LAHF and CF groups. The characteristics of these two groups of patients had no statistical significant difference. For the CF group, 70 Gy were given in 35 fractions over 49 days. For the LAHF group, radiotherapy were divided into two phases: 40 Gy in the first phase with fraction dose 2 Gy per day; 27 Gy during the second phase with 1.5 Gy per fraction and two fractions a day. The total dose in the LAHF group was 67 Gy in 38 fractions over 42 days. The chemotherapy was delivered concurrently with FUDR 500 mg/m2 and cisplatin 20 mg/m2 given twice weekly for 3 weeks. Results Acute esophagitis occurred in 100% and 87.5% of the patients in the LAHF group and the CF group, respectively. Grade 3/4 in LAHF group was 35%, being higher and longer than that in CF group (15%). Although 5.6% of the patients in the combined group developed grade 5 acute toxicity, none was noted in the LAHF alone group. The hematopoietic, gastriointestinal and pulmonary toxicities were not significantly different between LAHF group and CF group(P>0.05).Three patients in LAHF group and 1 patient in CF group discontinued radiotherapy because of esophagitis. Conclusion (1) LAHF plus concurrent chemotherapy is tolerable, although its toxicity is more serious than CF plus concurrent chemotherapy; (2) The hematopoietic, gastriointestinal and pulmonary toxicities are not significantly different between LAHF group and CF group. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|