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《三维适形后程加速超分割联合PF方案诱导同期化疗治疗中晚期食管癌的临床观察【本科临床》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、临床医学论文•三维适形后程加速超分割联合PF方案诱导同期化疗治疗中晚期食管癌的临床观察作者:王万伟,于长华,宋亚硕,万一元【摘要】目的评估三维适形并后程加速超分割联合PF方案同期放化疗治疗中晚期食管癌的临床疗效。方法病理证实的中晚期食管癌65例随机分为单放组33例和放化组32例;放疗均采用6/15MV・X线外照射。各组放疗前2/3疗程常规放疗1・8Gy/次,5次/周,共40Gy,后1/3疗程改用加速超分割治疗,1•5Gy/次,2次/天,间隔6h以上,全疗程总剂量70Gy;放化组配合PF方案化疗,治疗结束后
2、,按照食管癌诊治规范标准,比较两组疗效,第1、2、3年生存率及毒副反应。结果单放组CR36.4%,PR54.5%,1、2、3年生存率分别为39.4%'30.3%、24.2%;放化组CR43.8%,PR53.1%,1、2、3年生存率分别为68.8%、56.3%、50.0%,两者近期疗效无统计学差异(P>()・05),放化组生存率显著高于单放组(PvO・05);局部毒副作用两组比较差异无统计学意义(P>0・05),放化组全身毒副作用高于单放组(P<0・05)。结论三维适形后程加速超分割联合PF方案治疗能明显提
3、高中晚期食管癌的1、2、3年生存率,且不增加局部毒副反应。【关键词】三维适形;后程加速超分割放疗;PF方案;食管癌Abstract:ObjectiveToevaluatetheclinicaleffectsofconcurrentchemoradiotherapywith3D-CRTlate-coursehyperfractionatedacceleratedradiationtherapy(LCAHF)plustheprognosticfactors(PF)projeclinductiononinter
4、mediateandadvancedesophagealcarcinoma・Methods65patientspathologicallyconfirmedashavingintermediateoradvancedesophagealcarcinomawererandomlyallocatedintotwogroups(33inradiotherapygroupand32incomplexorchcmoradiothcrapygroup).Al1patientsweregivenexternalbeam
5、radiationof6/15MVX・ray.Duringthefirsttwo-thirdsofthecourse,thepatientsreceivedaroutinedoseof1.8Gyperfraction,fivetimesperweek,atadosageof40Gyinbothgroups.Fortheone-thidthatfollowed,LCAHFwasgivenatadoseof1.5Gy,twicedaily,atanintervalofmorethan6hours,withth
6、etotaldosageof70Gy.Incomplexgroup,chemotherapyregimenwascombinedwithDFproject・Attheendoftreatment,theefficiency,respectivesurvivalratesof1,2and3years,toxicityaswe11assideeffectsbetweenthetwogroupswerecompared,basedonGuidelinesforDiagnosisandTreatmentofEso
7、phagealCarcinomas.ResultsIntheradiotherapygroup,CRwas36.4%andPRwas54.5%,andinthecomplexgroup,CRwas43.8%andPRwas53.1%,respectively.The2・,3・yearsurvivalrateswere39.4%,30.3%,24.2%intheradiotherapygroupand68.8%,56.3%,50.0%inthecomplexgroup,respectively(P<0・05
8、)・Thedifferencebetweentheregionaltoxicityandsideeffectsinthetwogroupswerenotstatisticallysignificant(P>0.05),whileinthecomplexgroup,theregionaltoxicityandsideeffectswerehigherthanintheradiotherapygroup(P<0・05)・Concl