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目的 评价后程超分割放射治疗食管癌的疗效及放射反应。方法 对 96例食管癌随机分为后程超分割组 (后超组 )和常规组 ,每组 48例。经病理证实 76例 ,后超组 39例 ,常规组 37例 ,均为鳞癌。男性 6 5例 ,女性 31例。年龄 41～ 70岁 ,中位年龄 5 7.1岁。病变部位 :胸上段 2 1例 ,胸中段 6 3例 ,胸下段 12例。病变长度 :<5 .0cm 2 9例 ,5 .0～ 7.0cm 5 7例 ,>7.0cm 10例。全部采用60 Co外照射 ,常规组 1次 d ,2 .0Gy 次 ,5次 周 ,总剂量 6 4Gy,32分次 ,44d完成。后超组放射治疗前 2 3疗程同常规组 ,照射到 40Gy后改为 1.15～ 1.2 5Gy 次 ,2次 d ,间隔 6～ 8h ,使总剂量达到 6 8～ 70Gy ,44～45d完成。结果 随访率为 96 .9%。 1、3、5年生存率后超组为 81.1%、44 .1%、2 6 .8% ,常规组为 6 1.7%、2 5 .1%、16 .9%。后超组 1、3年生存率高于常规组 (u值为 2 .97及 2 .6 4,P <0 .0 1) ,5年生存率无显著性意义 (u =1.71,P >0 .0 5 )。后超组和常规组放射性食管炎的发生率分别为 2 7.1%及 16 .7%(χ2 =1.5 2 ,P =0 .2 0 ) ;放射性支气管炎的发生率后超组为 18.8% ,常规组为 12 .5 % (χ2 =0 .71,P =0 .40 )。结论 食管癌后程超分割治疗 1、3生存率高于常规组 ,患者对后程超分割所引起的副作用能够耐受不影
Objectives To evaluate the efficacy and radiation response of posterior hyperfractionated radiotherapy for esophageal cancer. Methods Ninety-six cases of esophageal cancer were randomly divided into two groups: posterior hyperfractionation group (post-supergroup) and conventional group, 48 cases in each group. Seventy-six cases were confirmed by pathology, 39 cases in the post-supergroup, and 37 cases in the conventional group. All were squamous cell carcinoma. There were 65 males and 31 females. Age 41 to 70 years, median age 5 7.1 years old. Lesions: 21 cases in upper chest, 63 in middle chest, and 12 in lower chest. Lesion length: <5. 0cm 2 9 cases, 5.0 ~ 7.0cm 5 7 cases,> 7.0cm 10 cases. All were treated with 60 Co external irradiation, conventional group 1 d, 2.0 Gy, 5 weeks, total dose 6 4Gy, 32 fractions, 44d completed. The post-Ultrasound radiotherapy treatment was performed in the same way as in the conventional group. After irradiation with 40 Gy, it was changed to 1.15 to 1.2 5 Gy, 2 d, and the interval was 6 to 8 hours, so that the total dose reached 6.8 to 70 Gy and was completed 44 to 45 days. Results The follow-up rate was 96.9%. The 1-, 3-, and 5-year survival rates were 81.1%, 44.1%, and 26.8% for the supergroup, and 6.7%, 25.1%, and 16.9% for the routine group. The postoperative 1-year and 3-year survival rates were higher than those in the conventional group (u values were 2.97 and 2.64, P < 0.01), and the 5-year survival rate was not significant (u = 1.71, P > 0). .0 5 ). The incidence of radioactive esophagitis in the post-supergroup and conventional group was 27.1% and 16.7%, respectively (χ2=1.52, P=0.20); the incidence of radiation bronchitis was 18.8% after the supergroup, conventional The group was 12.5% (χ2=0.71, P=0.40). Conclusions The survival rate of late-course hyperfractionation of esophageal cancer is higher than that of conventional group. The side-effects caused by hyper-fractionation of patients with late-course hyperplasia can be tolerated.