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目的 探讨同期应用顺铂能否提高后程加速超分割 (后超 )放射治疗食管癌的疗效。方法 对符合入组条件的 81例病例 ,随机分为后超组 41例 [常规分割 30Gy +加速超分割 (1.5Gy/次、2次 /d) 30Gy]和综合组 40例 [在后超组基础上静脉输注顺铂 (2 0mg/d、连用 5d为 1周期、分别在第 1、4周实施 )共 2个周期 ]。结果 综合组和后超组的 1、3年生存率分别为 80 .0 %、73.2 %和 40 .0 %、34 .2 % ,但无统计学差异。肿瘤局限在食管壁的病例加用顺铂后生存率提高 ,综合组和后超组的 3年生存率分别为 6 6 .7%、2 5 .0 % (P <0 .0 5 ) ;早、晚期放射反应综合组较后超组高 ,综合组有 3例顽固性咽下疼痛 ,反复发作 3个月以上。结论 后程加速超分割放射治疗加用顺铂未能明显提高食管癌放射治疗的生存率 ,但对侵润局限在食管壁的病例能明显提高 3年生存率。
Objective To investigate whether cisplatin in the same period can enhance the effect of late-course accelerated hyperfractionation (post-ultrasonography) radiation on esophageal cancer. Methods A total of 81 cases were enrolled in this study. They were randomly divided into the post-super-group of 41 cases (30Gy + 30Gy accelerated hyperfractionation (1.5Gy / time, 2 times / d) On the basis of intravenous infusion of cisplatin (20mg / d, 5d for 1 cycle, respectively, in the first and fourth weeks of implementation) a total of 2 cycles]. Results The 1-year and 3-year survival rates of the combined group and the post-super-group were 80.0%, 73.2% and 40.0%, 34.2% respectively, but there was no statistical difference. Survival rate of tumor in the esophageal wall was increased after cisplatin was added. The 3-year survival rates of the combined group and the post-super-group were respectively 6.67% and 25.0% (P <0.05). The early and late radiotherapy combined group was higher than the later super-group. The combined group had 3 intractable swallowing pains, and repeated attacks for more than 3 months. Conclusions Post-course accelerated hyperfractionation radiotherapy plus cisplatin did not significantly improve the survival rate of esophageal cancer radiotherapy, but the invasion of the esophageal wall in the case of patients can significantly improve the 3-year survival rate.