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目的比较后程加速超分割放疗加同期化疗与单纯后程加速超分割放疗治疗食管癌的近期疗效及毒副作用。方法 78例中上段食管癌患者随机分为两组。1)单纯后程加速超分割放疗组36例;2)后程加速超分割放疗加同期化疗组42例。放疗采用6MVX线外照射,前2/3程常规放射治疗2Gy/次,1次/d,共40次,后1/3疗程改用加速超分割放射治疗,1.2Gy/次,2次/d,间隔6h,全疗程总剂量共65Gy;化疗采用周剂量紫杉醇全身用药方案,30mg静脉滴注,每周一放疗前给药1次,共6次,用药前给予预处理。结果同步放化疗组近期有效率为83.3%,1、3、5年生存率分别为71.4%、42.8%和28.5%;单放组的近期有效率为63.8%,1、3、年生存率分别为47.2%、27.7%和13.8%。经χ2检验,差异有显著意义,两组毒副作用均可以耐受。结论以紫杉醇化疗同步后程加速超分割放疗可以提高食管癌的近期有效率及长期生存率,毒副反应所有患者均能耐受。
Objective To compare the short-term effects and side effects of late-course accelerated hyperfraction radiotherapy plus concurrent chemotherapy and simple late-course accelerated hyperfraction radiotherapy in the treatment of esophageal cancer. Methods 78 cases of upper esophageal cancer were randomly divided into two groups. 1) Simple late-accelerated hyperfractionation radiotherapy in 36 cases; 2) Late accelerated laser plus hyper-fractionated radiotherapy plus concurrent chemotherapy in 42 cases. Radiotherapy using 6MVX line of radiation, the first 2/3 routine conventional radiotherapy 2Gy / time, 1 / d, a total of 40 times, 1/3 course of treatment switched to accelerated hyperfractionation radiotherapy, 1.2Gy / time, 2 times / d , An interval of 6h, the total dose of a total of 65Gy course of chemotherapy; weekly chemotherapy with paclitaxel whole body drug regimen, 30mg intravenous infusion, administered once a week before radiotherapy, a total of 6 times before treatment pretreatment. Results The effective rates of concurrent chemoradiotherapy and chemotherapy were 83.3% and 71.4%, 42.8% and 28.5% respectively in the concurrent chemoradiotherapy group and 63.8% in 1,3 and 5 years respectively 47.2%, 27.7% and 13.8% respectively. The χ2 test, the difference was significant, both side effects can be tolerated. Conclusions Paclitaxel chemotheraphy can accelerate the short-term effective rate and long-term survival rate of esophageal cancer by accelerating hyperfraction radiotherapy. The toxicities of all patients can be tolerated.