后程加速超分割放疗联合DF方案治疗食管癌的临床研究.docVIP

后程加速超分割放疗联合DF方案治疗食管癌的临床研究 牛永健 宋祥玉 河南省林州市人民医院 放疗科 河南 林州 456550 [摘要]：目的 探讨后程加速超分割放疗联合DF方案治疗食管癌的疗效。方法：180例食管癌患者，随机分为A组90例，后程加速超分割并DF方案组，前程先给予常规分割2Gy/f，1f/d，5f/w，总Dt=36Gy/18f/3.5w 后程1.5Gy/f，2f/d，10f/w，间隔时间6h，总Dt=51~60Gy/28f~34f/4.5~5.0w；B组90例，常规分割联合DF方案组，2Gy/f，1f/d，5f/w，总Dt=60~70Gy/30f~35f/6~7w。结果：A组和B组的1、3、5年生存率分别为71.1%,40.6%,32,1%和51.1%,22.2%,14.4%,统计学处理后,两组有显著性差异(p0.01),后程超分割组明显优于常规组;而放射性急性损伤和晚期损伤率,经卡方检验后,两组无显著性差异(p0.05)。结论：后程超分割联合DF方案治疗食管癌可以提高食管癌患者的长期生存率，并缩短住院时间而不明显增加放射性损伤，是目前一种切实可行的新的综合治疗方法。 [关键词] 后程加速；超分割；DF方案；食管癌 [Abstract]：Objective：To study therapic effects of late course accelerated hyperfractionation radiotherapy(LCAHR) for esophagus;Methods:180 patients with esophagus were randomized into two groups(A and B),Agroup has 90 patients,That is, LCAHR group;B group has still 90 patients, That is the conventional fractionation radiotherapy(CFR); Agroup rectived the Dt 51~60Gy/34~40f/4.5~5.0w,above course , conventional fractionation : 2Gy/f，1f/d，5f/w，Dt=36Gy/18f/3.5w . Late course accelerated hyperfractionation:1.5Gy per once,2 fractions per day,5 days per week,over 6 hours between the minimium interfaction interval time for two therapies;In B group,the Dt 60~70Gy/30f~35f/6~7w Were delivered.at 2 Gy per day,5 days per week; two groups ware entirely combined with DF plan;Results:the 1-.3-.5-year survival rates were 71.1%,40%,31,1% in A group and 51.1%,22.2%,14.4%, in B group,respectively.the survival rates in A group were much better than those in B group(p0.01).There was no significant differences on acute injury of radiotherapy between two groups(p0.05).Conclusions:The results from this study that the LCAHR improves the long-term survival of esophagus without increasing the complication of radiotherapy,It is a feasiable and new comprehensive therapy means. [Key words] Late course accelerated hyperfractionation radiotherapy DF plan esophagus cancer 放射治疗是治疗食管癌的主要手段之一。近40多年来，食管癌常规放射治疗的5年生存率一直徘徊在10%左右，由于放射生物学的发展给非常规放射治疗提供了理论依据。目前，国内外采用后程加速超