食管癌后程加速超分割三维适形放疗与食管癌后程加速超分割放疗的疗效评价.docVIP

食管癌后程加速超分割三维适形放疗与食管癌后程加速超分割放疗的疗效评价 【关键词】 放射剂量分次；适形；食管肿瘤/放射疗法 ［摘要］ 目的 评价后程加速超分割三维适形放疗与食管癌后程超分割放疗的疗效。方法 将54例食管鳞癌患者前瞻随机分组至后程加速超分割三维适形放疗(LCAH3DCRT)组和后程加速超分割放疗(LCAHRT)组。放疗方法均为前2/3天疗程普通模拟机定位常规放疗40 Gy，后1/3疗程LCAH3DCRT组改为CT模拟定位加速超分割三维适形放疗(1.6 Gy/次，2次/d，5 d/周，20～28 Gy)，总剂量为60～68 Gy，全疗程37～40天；LCAHRT组加速超分割放疗至上述相当剂量。 结果 LCAH3DCRT组和LCAHRT组5年生存率分别为31%和22%，LCAH3DCRT组生存率高于LCAHRT组(P=0.028)；3、4、5年无瘤生存率分别为34%、32%、31%和28%、26%、21%，LCAH3DCRT组无瘤生存率均高于LCAHRT组(P值均＜0.05)。LCAH3DCRT组和LCAHRT组1、2、3、4、5年局部控制率分别为78%、73%、61%、59%、56%和58%、37%、30%、28%、25%，LCAH3DCRT组局部控制率高于LCAHRT组(P值均＜0.05)。 结论 后程加速超分割三维适形放疗可作为食管癌的首选方法之一，它提高了5年生存率和局部控制率。 ［关键词］ 放射剂量分次；适形；食管肿瘤/放射疗法 Evaluation on latecourse accelerated hyperfractionated threedimensional conformal radiotherapy for esophageal carcinoma and latecourse accelerated hyperfractionated radiotherapy for esophageal carcinoma ［Abstract］ Objective To evaluate the treatment results of latecourse accelerated hyperfractionated threedimensional conformal radiotherapy for esophageal carcinoma and latecourse accelerated hyperfractionated radiotherapy for esophageal carcinoma. Methods 54 esophageal carcinoma patients were divided randomly into two groups:LCAH3DCRT group27 patients were treated by conventional fractionated radiotherapy during the first twothirds of course with 40 Gy,then followed by hyperfraction 3DCRT with 20～28 Gy,1.6 Gy perfraction,2 times a day,5 days aweek,to a total dose of 60～68 Gy in 33～40 fractions over 37～40 days;LCAHRT group-27 patients were treated with the same method during the twothirds,then followed by accelerated hyperfractionated radiotherapy with the same dose.Results The 5-year survival rate was 31% and 22% in LCAH3DCRT and LCAHRT group,respectively(P=0.028).The 3-,4-,and 5-year tumorfree survival rate was 34%,32%,31% and 28%,26%,21% in LCAH3DCRT and LCAHRT group,respectively(all P＜0.05).The 1-,2-,3-,4-,and 5-year local control rate was 78%,73%,61%,59%,56% and 58%,37%,30%,28%,25% in LCAH3DC