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目的观察化疗同步后程加速超分割放疗食管癌耐受性和毒性反应。方法放疗采用6MVX线外照射,前2/3程常规放射治疗2Gy/次,每日一次,共40次,后1/3疗程改用加速超分割放射治疗,1.5Gy/次,每日2次,间隔6h,全疗程总剂量共66Gy;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。结果毒性反应主要是白细胞减少,III～IV级骨髓抑制41.3%,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同步化疗有提高食管癌生存率的趋势,但并不增加晚期放射反应。
Objective To observe the accelerated and hyperfractionated radiotherapy for esophageal cancer tolerance and toxicity after chemotherapy. Methods Radiotherapy was performed with 6MVX external irradiation. The first 2/3 sessions of conventional radiotherapy were performed 2Gy/time once a day for 40 times. The latter 1/3 course of treatment was switched to accelerated hyperfractionated radiation therapy, 1.5Gy/time, 2 times a day. , 6h interval, the total dose of a total treatment of 66Gy; chemotherapy using weekly dose of paclitaxel systemic administration program, intravenous infusion of 30mg, weekly radiotherapy 1 dose, a total of 6 times, pretreatment with premedication. RESULTS: The toxicity was mainly leukopenia, and myelosuppression of grades III to IV was 41.3%. There was no significant difference in the incidence of late radioresponses between the two groups. Radioactive esophageal stenosis and pulmonary fibrosis were mainly observed. Conclusions Compared with purely accelerating hyperfractionated radiation therapy, late-course accelerated hyperfractionated radiotherapy with synchronous chemotherapy has the potential to increase the survival rate of esophageal cancer, but does not increase the late radiation response.