CAJ | 학술논문

目的分析后加速放射治疗食管癌的疗效。方法自1997年8月至1998年4月对73例经病理证实的食管鳞癌病人，随机分为两组：常规组(36例)、后加速组(37例)。常规组照射：180CGY/次/日，5次/周，总剂量为66.6GY/7.4周。后加速组照射：前程为180CGY/ 次/日，5次/周，剂量达43.2GY/4.6周，后改为150CGY/次，2次/日，间隔6小时以上，10次/ 周，总剂量为67.2GY/6.4周。结果两组照射结束时，局控率无明显的差异，后加速组1年生存率和局控率分别为86.5%(32/37)和78.4%(29/37)，常规组分别为52.8% (19/36)和50%(18/36)，后加速组疗效明显高于常规组(P<0.05)，后加速组放疗副反应和并发症无明显增加，后加速组死于复发的比例比常规组低，分别为10.8%(4/37)和36.11%(13/3 6)(P<0.05)，两组的主要死因是局部复发，其次是远处转移，常转至肝和肺。结论后加速组放疗技术对于食管癌患者的放射治疗，是一种比较合理有效的照射方法，不增加放疗副反应和并发症，能否提高食管癌的长期生长率，有待长期大量的病例研究。
목적분석후가속방사치료식관암적료효。방법자1997년8월지1998년4월대73례경병리증실적식관린암병인，수궤분위량조：상규조(36례)、후가속조(37례)。상규조조사：180CGY/차/일，5차/주，총제량위66.6GY/7.4주。후가속조조사：전정위180CGY/ 차/일，5차/주，제량체43.2GY/4.6주，후개위150CGY/차，2차/일，간격6소시이상，10차/ 주，총제량위67.2GY/6.4주。결과량조조사결속시，국공솔무명현적차이，후가속조1년생존솔화국공솔분별위86.5%(32/37)화78.4%(29/37)，상규조분별위52.8% (19/36)화50%(18/36)，후가속조료효명현고우상규조(P<0.05)，후가속조방료부반응화병발증무명현증가，후가속조사우복발적비례비상규조저，분별위10.8%(4/37)화36.11%(13/3 6)(P<0.05)，량조적주요사인시국부복발，기차시원처전이，상전지간화폐。결론후가속조방료기술대우식관암환자적방사치료，시일충비교합리유효적조사방법，불증가방료부반응화병발증，능부제고식관암적장기생장솔，유대장기대량적병례연구。
Objective　To analysis the curative effect of post accelerative irradiation on esophogeal cancer.Methods　73 patho logically dignosed patients with esophageal cancer since April,1998 were randomi zed into conventional group(36 patients)and post accelerative guoup(37 patients) .The irradiative dose of the conventional group was 180 CG/time/day;5 times/week and the total dose was 66.6GY in 7.4 weeks.The irradiative dose of the accelera te group was 180GY/time/day previously,5times/week and the total dose was 43.2GY /4.6 weeks,followed by 150 CGY/time,twice/day,and an interval of over 6 hours 10 times/seek,the total does was 67.2GY/6.4 weeks.Results　It ende d up with no significant difference of local control rate between the two groups .The one-year survival rate and the local control rate of the post accelerate g roup was 86.5%(32/37)and 78.4%(29/37) respectively while the conventional group was 52.8%(19/36)and 50%(18/36)respectively.The curative effect of the post accel erative group was obviously better than that of the conventional group(P<0.05).N o increasing side-effect or complication was observed in accelerative group.The causes of death of the two groups were local recurrence and the distant metastasis, mostl y in liver and lungs.Conclusions　The post accelerative radiothe rapy is more reasonable and effective in the treatment of the patients with esop hageal cancer without increasing the side-effect of the radiotherapy and compli cations.It needs to be further studied whether it can prolong the long-term sur vival of the patients with esophageal canceror not.