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目的采用前瞻随机性研究，探讨后程加速超分割放疗（ｌａｔｅｃｏｕｒｓｅａｃｃｅｌｅｒａｔｅｄｈｙｐｅｒｆｒａｃｔｉｏｎａｔｉｏｎｒａｄｉｏｔｈｅｒａｐｙ，ＬＣＡＨＲ）能否提高中胸段食管癌疗效。材料与方法１９９２年４月到１９９４年６月，１０４例中胸段食管癌经分层随机分加速超分割治疗组（Ｅ组）５１例，常规治疗组（Ｃ组）５３例，两组患者一般临床资料差异无统计学意义。放射总剂量Ｅ组：６５．６±１．９Ｇｙ，照射３６（３４～３８）次／３８（３６～４７）天；Ｃ组：总剂量６６．０±１．３Ｇｙ，照射３３（３２～３４）次／４５（４３～５０）天。结果急性放射性食管炎Ｅ组８８％，Ｃ组７２％（Ｐ＝０．０１５）。Ｅ组在不同随访期有２例死于食管大出血，１例出现放射性肺炎。１，２，３年局控率Ｅ组为７８％、５７％、４３％而Ｃ组为５８％、３６％、２６％（Ｐ＝０．０４７）；１，２，３年生存率Ｅ组为７５％、５１％、４１％而Ｃ组为５６％、３６％、２３％（Ｐ＝０．０４２）。结论（１）后程加速超分割放疗能为患者耐受。（２）后程加速超分割放疗提高了局控及生存率。
Objective To investigate the effect of late course accelerated hyperfractionation radiotherapy (LCAHR) on the efficacy of middle-thoracic esophageal cancer in prospective randomized studies. Materials and Methods From April 1992 to June 1994, 104 patients with mid-thoracic esophageal cancer were randomly divided into accelerated hyperfractionation group (E group), 51 cases, and conventional treatment group (C group), 53 cases. There was no statistically significant difference in general clinical data. The total dose of radiation E group: 65.6 ± 1.9Gy, irradiation 36 (34 ~ 38) / 38 (36 ~ 47) days; C group: the total dose of 66.0 ± 1.3Gy, irradiation 33 (32 ~ 34 )/45 (43-50) days. Results Acute radiation esophagitis occurred in 88% of E group and 72% of C group (P=0.015). In group E, 2 patients died of esophageal hemorrhage and 1 patient had radiation pneumonia during different follow-up periods. The 1-, 2-, and 3-year local control rates were 78%, 57%, and 43% in group E, and 58%, 36%, and 26% in group C (P=0.047); 1, 2, and 3 years survival rate in group E. They were 75%, 51%, and 41%, while those in group C were 56%, 36%, and 23% (P=0.042). Conclusions (1) Late course accelerated hyperfractionated radiotherapy can be tolerated by patients. (2) Late-course accelerated hyperfractionated radiotherapy improves local control and survival.