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目的 :探讨中后程加速超分割放射治疗食管癌的疗效及早期放射反应和晚期损伤。方法 :本文对 5 9例食管鳞癌随机分为 2组 :常规分割放疗组 2 9例 ,2Gy/次 ,1次 /d ,5次 /wk ,总量 72Gy/7 2wk ;后程加速超分割放疗组 3 0例 ,前 1/2疗程同常规组 ,共 3 0Gy/3wk ,从第 4wk开始 2次 /d ,1 4Gy/次 ,间隔 6h以上 ,待总量达 4 1 2Gy时缩野至总量 72Gy/6wk。结果 :后加速组 1年生存率和局控率分别为 70 %和 73 9% ,明显高于常规组的 3 9 1%和 4 2 3 % (P <0 0 5 ) ;放疗结束后 3mo活检病理两组均为中、重度放疗反应 ,无显著性差异 (P >0 0 5 ) ;放疗结束时后加速组吞咽梗阻症状的改善优于常规组 ,有非常显著性差异 (P <0 0 1) ;放疗副反应后加速组稍多于常规组 ,但无显著性差异 ,晚期损伤后加速组也未见增加。结论 :研究初步表明 ,中后程加速超分割放射治疗能明显提高食管癌患者 1a生存率和局控率 ,不明显增加放疗副反应及晚期损伤。
Objective : To explore the efficacy of midcourse and late-course accelerated hyperfractionated radiotherapy for esophageal cancer and early radiation and late injury. Methods: Fifty-nine cases of esophageal squamous cell carcinoma were randomly divided into 2 groups: 29 cases with conventional segmentation radiotherapy group, 2Gy/time, 1time/d, 5 times/wk, total 72Gy/72wk; late-course accelerated hyperfractionation Radiotherapy group 30 cases, the first 1/2 course with the regular group, a total of 30Gy/3wk, from the 4wk 2 times / d, 1 4Gy / time, interval 6h or more, when the total amount reached 4 1 2Gy shrink to the Total 72Gy/6wk. Results: The 1-year survival rate and local control rate in the post-acceleration group were 70% and 73.9%, respectively, which were significantly higher than those in the conventional group (39.1% and 4.23%) (P < 0.05); biopsy 3 months after the end of radiotherapy. Pathological changes in both groups were moderate to severe radiotherapy and there was no significant difference (P > 0.05). The improvement of swallowing obstruction symptoms in the accelerated group was better than that in the conventional group at the end of radiotherapy. There was a significant difference (P <0 0 1). ); After radiotherapy, the accelerated reaction group was slightly more than the conventional group, but there was no significant difference. There was no increase in the accelerated group after the late injury. Conclusions: The study initially showed that the mid-course accelerative hyperfractionation radiotherapy can significantly improve the 1a survival rate and local control rate of esophageal cancer patients, and does not significantly increase the side effects of radiotherapy and late-stage injury.