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1、食管癌后程加速超分割放射治疗同步化疗的远期疗效作者：段永建，唐文春,韩晓莉，王志伟【摘要】目的：评价后程加速超分割放射治疗加顺钳、氟尿曜唳同步化疗治疗食管癌的远期疗效和毒副反应.方法：115例食管癌患者随机分成单纯后程加速超分割放射治疗组（后超组）58例和后程加速超分割放射治疗加顺鸽、氟尿卩密喘同步化疗组（综合组）57例.后超组前2/3疗程为常规分割（2Gy/次，5次/wk）照射36~40Gy后缩野改加速超分割（1.5Gy/次，2次/d）照射27〜30Gy.综合组在后超组的基础上静脉内输注顺钳20mg/d,氟尿卩密唳500mg/d,连用5d为1周期.分别在第
2、1,4wk实施，共2个周期.结果：综合组1,3和5a生存率（分别为80.7%,50.9%和40.4%）稍优于后超组（分别为74.1%,34.5%和25.9%）,但差异无显著性（x2=3.392,P二0.070）・两组晚期放射反应发生率差异无显著性，主要为放射性食管狭窄和肺纤维化.结论：与单纯后程加速超分割放射治疗相比,后程加速超分割放射治疗加顺钳、氟尿卩密噪同步化疗有提高食管癌5a生存率的趋势，但并不增加晚期放射反应.【关键词】食管肿瘤/放射疗法；放射剂量分次；食管肿瘤/药物疗法;综合疗法【Abstract]AIM:Toinvestigatethelongt
3、ermefficacyandadverseeffectsoflatecourseacceleratedhyperfractionation(LCAH)radiotherapycombinedwithcisplatinandfluorouracilchemotherapyforesophagealcarcinoma.METHODS:Of115consecutivepatientswithesophagealcarcinoma,57caseswererandomlyassignedtocombinedtreatmentgroupofLCAHradiotherap
4、yandsynchronouschemotherapybycisplatinandfluorouracil,and58casestosimplehyperfractionationgroup(HF).Al1patientsinHFgroupweretreatedwithconventionalfractionationregimenduringthefirsttwothirdsofthecoursewithtotaldose3640Gy(2Gy/fraction，5timesaweek),followedbyLCAHinreducedfields,withd
5、oseof2730Gy(1.5Gy/fraction,twiceaday).Patientsincombinedtreatmentgroup,inadditiontoLCAH,intravenousinfusionofcisplatin20mg/d,andfluorouracil500mg/d,wasgivenfor5consecutivedaysasacourseinweek1and4.RESULTS:The1,2and5yearsurvivalratesincombinedtreatmentgroup(80.7%,50.9%,and40.4%,respe
6、ctively)seemedtobesuperiortothoseinHFgroup(74.1%,34.5%,and25.9%,respectively),however,nomarkedimprovementwasestablished(x2=3.392,P=0.070).Nosignificantdifferencesbetweenthemaincommonlateadversereactionsinthetwogroupswerefound,includingesophagealstrictureandlungfibrosis.CONCLUSION:I
7、ncomparisonwithHF,thecombinedtreatmenttendstopromotethe5yearsurvivalrate,yetdoesnotincreasethelateadversereactions.【Keywords】esophagealneoplasms/radiotherapy;dosefractionation;esophagealneoplasms/drugtherapy;combinedmodalitytherapy0引言食管癌同期放化疗在北美和日本已成为非手术治疗的标准方案[1-2].在国内，后程加速超分割放射治疗
8、食管癌也显示了较好的疗效，5a生存率达30%左右[3
