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1、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，宋亚颀，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，按照食管癌诊治
2、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>0．05)，放化组生存率显著高于单放组(P<0．05)；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
3、显提高中晚期食管癌的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9Abstract：ObjectiveToevaluatetheclinicaleffectsofconcurrentchemoradiotherapywith3D-CRTlate-coursehyperfractionatedacceleratedradiationtherapy(LCAHF)plustheprognosticfactors(PF)projectinductiononint
4、ermediateandadvancedesophagealcarcinoma.Methods65patientspathologicallyconfirmedashavingintermediateoradvancedesophagealcarcinomawererandomlyallocatedintotwogroups(33inradiotherapygroupand32incomplexorchemoradiotherapygroup).Allpatientsweregivenexternalbea
5、mradiationof6/15MVX-ray.Duringthefirsttwo-thirdsofthecourse,thepatientsreceivedaroutinedoseof1.8Gyperfraction,fivetimesperweek,atadosageof40Gyinbothgroups.Fortheone-thidthatfollowed,LCAHFwasgivenatadoseof1.5Gy,twicedaily,atanintervalofmorethan6hours,withth
6、etotaldosageof70Gy.Incomplexgroup,chemotherapyregimenwascombinedwithDFproject.Attheendoftreatment,theefficiency,respectivesurvivalratesof1,2and3years,toxicityaswellassideeffectsbetweenthetwogroupswerecompared,basedonGuidelinesforDiagnosisandTreatmentofEsop
7、hagealCarcinomas.ResultsIntheradiotherapygroup,CRwas36.4%andPRwas54.5%,andinthecomplexgroup,CRwas43.8%andPRwas53.1%,respectively.The1-,2-,3-yearsurvivalrateswere39.4%,930.3%,24.2%intheradiotherapygroupand68.8%,56.3%,50.0%inthecomplexgroup,respectively(P<
8、;0.05).Thedifferencebetweentheregionaltoxicityandsideeffectsinthetwogroupswerenotstatisticallysignificant(P>0.05),whileinthecomplexgroup,theregionaltoxicityandsideeffectswerehigherthanintheradiotherapygrou
