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目的回顾分析和比较后程加速超分割放疗(后超组)与常规分割+腔内放疗(腔内组)食管癌的疗效。方法对1994年5月至1999年11月间4个小样本前瞻性研究的后超组(135例)和腔内组(130例)治疗食管癌的病例进行分析比较。后超组前3周常规分割照射3000cGy(分15次3周完成),后2周采用加速超分割照射3000cGy(分20次2周完成;150cGy/次,2次/d,2次相隔6h,5d/周)。腔内组常规分割照射5000cGy(分25次5周完成)+腔内照射1000cGy(分2次)。结果后超组和腔内组1、3、5年总生存率分别为61.8%、27.9%、19.9%和53.5%、25.2%、18.4%(P>0.05)。后超组和腔内组急性放射性食管炎的发生率分别为61.5%和57.0%(P=0.235),且RTOG分级3级食管炎比较两组差异也无统计学意义。结论两种放疗方式食管癌的生存率无明显差别,但后程加速超分割技术操作方便,易于在临床中实施。
Objective To retrospectively analyze and compare the effects of late-accelerated hyperfraction radiotherapy (post-super-group) and conventional intra-cavity radiotherapy (intracavitary group) esophageal cancer. Methods Four cases from May 1994 to November 1999 were retrospectively analyzed. The data of 135 cases treated by esophageal cancer and 130 cases treated by esophageal cancer were analyzed and compared. After the first three weeks after the super-group conventional irradiation 3000cGy (15 times 3 weeks to complete), 2 weeks after accelerated hyperfractionated irradiation 3000cGy (20 times 2 weeks to complete; 150cGy / times, 2 times / d, 2 times separated by 6h, 5d / week). Conventional intracavitary irradiation 5000cGy (divided into 25 times 5 weeks to complete) + intracavity 1000cGy (divided into 2 times). Results The overall 1, 3, 5-year overall survival rates were 61.8%, 27.9%, 19.9% and 53.5%, 25.2% and 18.4%, respectively (P> 0.05). The incidences of acute esophagitis in the posterior and endocervical groups were 61.5% and 57.0%, respectively (P = 0.235). There was also no significant difference in RTOG grade 3 esophagitis between the two groups. Conclusion There is no significant difference in the survival rates between the two radiotherapy esophageal carcinomas, but the late accelerated hyperfractionation technique is easy to operate and easy to implement in clinical practice.