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目的评价颈段、胸上段食管鳞癌三维适形放射治疗的疗效。方法82例颈段、胸上段食管鳞癌病例,随机分为三维适形后程加速超分割(后加速组)和常规分割(常规组)两组。常规组总剂量64￣66Gy,6.5周完成。后加速组为前3周采用常规分割,后2周采用超分割方法。结果两组近期疗效比较无明显差异,后加速组1,2,3年局部控制率分别为68.3%,45.0%,45.0%,常规组分别为52.6%,30.1%,27.4%,两组比较差异无统计学意义(χ2=3.01,P=0.08);后加速组1,2,3年生存率分别为73.2%,42.2%,39.4%,常规组分别为61.0%,31.7%,26.8%,两组比较差异无统计学意义(χ2=1.46,P=0.22)。结论三维适形放疗剂量分布均匀,周围正常组织受量减少,后程加速超分割放射治疗有望提高食管癌的疗效,局部肿瘤复发和未控仍是失败的主要原因,是否需要提高放射治疗剂量有待于临床进一步研究。
Objective To evaluate the efficacy of three-dimensional conformal radiotherapy for cervical and thoracic esophageal squamous cell carcinoma. Methods 82 cases of esophageal squamous cell carcinoma of the upper and lower thoracic spine were randomly divided into two groups: accelerated hyperfractionation (post-acceleration group) and conventional segmentation (conventional group). The conventional group total dose of 64 ~ 66Gy, 6.5 weeks to complete. Post-acceleration group for the first 3 weeks using conventional segmentation, after 2 weeks using super-segmentation method. Results There was no significant difference in short-term curative effect between the two groups. The local control rates in post-acceleration group were 68.3%, 45.0% and 45.0% at 1, 2 and 3 years respectively, compared with 52.6%, 30.1% and 27.4% There was no statistical significance (χ2 = 3.01, P = 0.08). The 1, 2, 3-year survival rates of the post-acceleration group were 73.2%, 42.2% and 39.4% respectively, compared with 61.0%, 31.7% and 26.8% The difference was not statistically significant (χ2 = 1.46, P = 0.22). Conclusions Three-dimensional conformal radiotherapy dose distribution is uniform, the amount of normal tissue around the reduction, accelerated posterior accelerated radiation therapy is expected to improve the efficacy of esophageal cancer, local tumor recurrence and uncontrolled is still the main reason for failure, whether the need to improve the dose of radiation therapy In clinical further research.