目的：探讨采用大分割适形放射治疗中晚期食管癌的近期疗效和毒副反应。方法将符合入组条件的49例中晚期食管癌患者行适形放射治疗，并随机分为两组。常规分割适形放疗组21例，每次剂量2．0 Gy，总剂量60．0～68．0 Gy；大分割适形放疗组28例，每次剂量2．4～3．0 Gy，总剂量60．0～62．5 Gy。两组均为每天照射1次，每周5次，以95％等剂量曲线作为剂量参考线。结果常规分割组和大分割组有效率分别为90．5％和92．9％；1年局控率分别为76．2％和82．1％；1年生存率分别为66．7％和71．4％；大分割组放射性食管炎及白细胞下降略高于常规分割组，差异无统计学意义（P＞0．05）。结论采用大分割三维适形放疗治疗中晚期食管癌是可行的。%Objective To explore the short-term curative effect and adverse reaction of hypofractionated conformal radiation therapy in treating advanced esophageal carcinoma .Methods Forty-nine patients with advanced esophageal carcinoma that would be treated with conformal radiotherapy were recruited in this study and were divided into two groups ,i.e.the conventional fractionation group which included 21 patients and were treated with the routine dose (2.0 Gy daily and the accumulated total dose was 60.0~68.0 Gy);the hypofractionated group which included 28 patients and were treated with hypofractionated conformal radiation therapy (2.4~3.0 Gy daily and the accumulated total dose was 60.0~62.5 Gy).Two groups were all treated once a day ,five times a week.The 95% of the isodose curve was taken as the reference dose curve.Results The response rates of the conventional group and the hypofractionated were 90.5%and 92.9%,respectively, 1-year local control rates were 76.2%and 82.1%,respectively,and 1-year survival rates were 66.7%and 71.4%,respectively.Besides,the rates of acute radiation-induced esophagitis and leucopenia in the hypofractionated group were a bit higher than those in the conventional group,but without statistical significance .Conclusions It is feasible to apply hypofractionated three-dimensional conformal radiotherapy in the treatment of advanced esophageal carcinoma .
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