目的探讨食管癌后程加速超分割放疗联合腔内加热的疗效。方法91例食管癌患者进入单纯后程加速超分割放疗(单放组)和后程加速超分割放疗联合腔内加热(热放组)的前瞻性随机对照研究,其中单放组44例,热放组47例。放疗前2/3疗程常规分割,1.8Gy/次,共41.4Gy,23分次,4～5周完成;后1/3疗程缩野加速超分割放疗,1.5Gy/次,2次/d,间隔6h,共27Gy,18分次;总剂量68.4Gy,41分次。热放组在常规分割期间每周腔内加热1次,共4次。结果单放组和热放组治疗结束时CR率分别为47.7%和72.3%,PR率分别为52.3%和27.8%(P=0.016)。中位生存时间单放组和热放组分别为30.3和30.6个月。1、2、3年生存率单放组和热放组分别为77.3%、57.4%、37.3%和80.5%、68.6%、46.3%(P=0.526),1、2、3年局部控制率分别为86.3%、70.5%、56.5%和92.4%、72.5%、65.5%(P=0.686)。单放组与热放组的3级急性放射性食管炎发生率分别为18.2%和27.6%(P=0.498),3级急性放射性气管炎分别为11.4%和19.2%(P=0.191)。结论食管癌后程加速超分割放疗联合腔内加热的即期疗效优于单纯后程加速超分割放疗,腔内加热没有明显增加后程加速超分割放疗的毒性反应。 Objective To investigate the effect of late course of esophageal cancer accelerated hyperfraction radiotherapy combined with intraluminal heating. Methods A total of 91 patients with esophageal cancer were enrolled into the prospective randomized controlled trial of accelerated hyperspectral radiation after radiotherapy alone (combined with radiotherapy alone) and late-accelerated hyperfraction radiotherapy combined with intraluminal heating (radiotherapy alone). Among them, 44 Put the group of 47 cases. Radiotherapy before the 2/3 course of routine segmentation, 1.8Gy / time, a total of 41.4Gy, 23 times, 4 to 5 weeks to complete; 1/3 after the treatment of shrinkage hyperactivity radiotherapy, 1.5Gy / time, 2 times / An interval of 6h, a total of 27Gy, 18 times; total dose of 68.4Gy, 41 times. The heat release group was heated in the cavity once per week for 4 times during the conventional division. Results The CR rates of the radiotherapy group and the radiotherapy group were 47.7% and 72.3%, respectively. The PR rates were 52.3% and 27.8%, respectively (P = 0.016). The median survival time was 30.3 and 30.6 months in the radiotherapy and radiotherapy groups, respectively. The 1, 2 and 3-year survival rates were 77.3%, 57.4%, 37.3% and 80.5%, 68.6% and 46.3% in the radiotherapy group and the radiotherapy group respectively (P = 0.526) Were 86.3%, 70.5%, 56.5% and 92.4%, 72.5% and 65.5%, respectively (P = 0.686). The incidences of grade 3 acute radiation esophagitis were 18.2% and 27.6% in the radiotherapy group and in the radiotherapy group respectively (P = 0.498). The grade 3 acute radiation-induced bronchitis was 11.4% and 19.2%, respectively (P = 0.191). Conclusions Accelerated esophagectomy after hyperfractionated radiotherapy combined with intracavitary heating is superior to the late-accelerated hyperfractionated radiotherapy alone. No significant increase in late-stage accelerated hyperfractionated radiotherapy toxicity was observed after intraluminal heating.