Title: Clinical Study of a Combination Regimen with Late Course Accelerated Hyperfractionated Comformal Radiotherapy and Concurrent Chemotherapy in Esophageal Carcinoma
Abstract: Objective To analyze the curative effect,tolerance and toxic side effects of late course accelerated hyperfractionation three-dimensional conformal radiotherapy(LCAH-3DCRT)combined with concurrent chemotherapy in patients with esophageal carcinoma.Methods Eighty patients with advance esophageal squamous cell were divided randomly into two groups:conventional radio-chemotherapy group(CRC group)and LCAH group,all of this patients didn't have distant metastasis and it's lesion extent were less than or equal to 12 cm.Patients in both groups were given 2 cycle chemotherapy before irradiation and 3 to 4 weeks after initiation of irradiation,respectively.The regimen was as follows:DDP 30 mg/m2 at day 1 to day 3,5-Fu 500 mg/m2 at day 1 to day 5,calcium folinate 0.2 ml at day 1 to day 5.Patients in CRC group were treated with conventional fractionation radiotherapy to a dose of 40 Gy,followed by a total dose of 64-70 Gy by reduced radiation field in 30-36 fractions over 35-45 days.Patients in LCAH group were initiated with a conventional irradiation to a dose about 30-36 Gy,which was then followed by accelerated hyperfractionation irradiation,twice daily at 1.5 Gy per fraction with a dose about 34-36 Gy,resulting in a total dose about 66-70 Gy over 35-42 days.Results The 1-,2-,3-,4-year overall survival was 69.5%,55.8%,43.7%,38.9% respectively for LCAH group,while in CRC group were 55.0%,39.7%,28.4%,22.1%,respectively,the difference was significant(P0.05).The 1-,2-,3-,4-year local control rate were 72.0%,62.6%,59.1%,55.2% respectively for LCAH group,while in CRC group were 64.6%,50.5%,47.1%,39.4%,respectively,the difference was not significant(P0.05).The rate of Ⅲ-Ⅳ esophagitis in LCAH group was higher than that in CRC group(P0.01).The difference of occurrences of the radiation-induced acute bronchitis,leukocyte decrease and pulmonary fibrosis were not statistical significant(P0.05).Conclusion Combination of LCAH-3DCRT and concurrent chemotherapy can improve overall survival of esophageal carcinoma,but may increase the risk of Ⅲ-Ⅳ esophagitis.
Publication Year: 2011
Publication Date: 2011-01-01
Language: en
Type: article
Access and Citation
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot