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目的 对比研究全程加速超分割 (CAHF)和后程加速超分割 (LCAF)放射治疗食管癌的远期疗效并进行多因素预后分析。方法 对 1 0 1例食管鳞癌患者进行前瞻性随机分组研究 ,其中49例进入CAHF组 ,52例进入LCAF组。CAHF组治疗开始 1 .5Gy/次 ,2次 /d ,5d/周 ,照射 39Gy,2 6分次后缩野继续上述方式治疗 ;总量 66Gy,44次 ,4.3周完成。LCAF组开始为常规分割 1 .8Gy/次 ,1次 /d ,5d/周 ,照射至 41 .4Gy,2 3分次缩野改为 1 .5Gy/次 ,2次 /d ;2次照射相隔≥ 6h,5d/周 ,总剂量68.4Gy,41分次 ,6 .4周完成。结果 1、2、3、4、5年局部控制率CAHF组分别为 85 .9%、83 .1 %、72 .6 %、72 .6 %、72 .6 % ,LCAF组分别为 81 .3 %、69.6 %、67.1 %、67.1 %、67.1 % ,2个组差别无显著性意义 (P =0 .37)。CAHF组中位复发时间为 1 0 .0个月 ,LCAF组为 7.5个月。 1、2、3、4、5年生存率CAHF组分别为 77.6 %、55 .1 %、42 .9%、37.5 %、37.5 % ,LCAF组分别为 82 .4%、58.8%、49.0 %、49 .0 %、39.2 % ,2个组差别无显著性意义 (P =0 .46)。 1、2、3、4、5年无瘤生存率CAHF组分别为64 .8%、51 .4%、35 .8%、35 .8%、35 .8% ,LCAF组分别为 66 .0 %、53 .9%、51 .8%、51 .8%、41 .5 % ,2个组差别无显著性意义 (P =0 .34)。 2个组晚期
Objective To compare the long-term efficacy of full-course accelerated hyperfractionation (CAHF) and late accelerated-stage hyperfractionated (LCAF) radiation in the treatment of esophageal cancer and to conduct a multivariate prognostic analysis. Methods One hundred and ten patients with esophageal squamous cell carcinoma were prospectively randomized into study group, of which 49 patients entered the CAHF group and 52 patients entered the LCAF group. CAHF group began treatment of 1.5 Gy / time, 2 times / d, 5d / week, irradiation 39Gy, 2 6 times subcontract after the above treatment; total 66Gy, 44 times, 4.3 weeks to complete. The LCAF group began to routinely divide 1.8 Gy / time, 1 time / d, 5 days / week, irradiated to 41.4 Gy, 2 3 times reduced to 1.5 Gy / time, 2 times / d; ≥ 6h, 5d / week, the total dose of 68.4Gy, 41 points, 6.4 weeks to complete. Results The local control rates at 1, 2, 3, 4 and 5 years were 85.9%, 83.1%, 72.6%, 72.6% and 72.6% in the CAHF group and 81.3% in the LCAF group %, 69.6%, 67.1%, 67.1%, 67.1% respectively. There was no significant difference between the two groups (P = 0.37). The median time to recurrence in the CAHF group was 100.0 months and in the LCAF group 7.5 months. The 1, 2, 3, 4, 5-year survival rates were 77.6%, 55.1%, 42.9%, 37.5% and 37.5% in the CAHF group and 82.4%, 58.8% and 49.0% in the LCAF group, 49.0% and 39.2%, respectively. There was no significant difference between the two groups (P = 0.46). The tumor-free survival rates at 1, 2, 3, 4 and 5 years were 64.8%, 51.4%, 35.8%, 35.8% and 35.8% in CAHF group and 66.0% in LCAF group %, 53.9%, 51.8%, 51.8%, 41.5%, respectively. There was no significant difference between the two groups (P = 0.34). 2 groups late