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Objective To evaluate the treatment results and side-reactions of esophageal carcinoma with late course hyperfractionated radiotherapy ( LCHR) plus different chemotherapy. Methods A prospective research was carried out on 287 advanced stage esophageal carcinoma patients whom were randomized into there groups;LCHR + cisplatin +5-fluorouracil +leucovorin group( A group), LCHR +5-fluorouracil polyphase lipo- some group (B group) and LCHR group(C group). 115 patients were in A group and 107 patients in B group and 65 patients in C group. Radiotherapy method; there groups were treated by conventional fractionated radio- therapy during the first two-thirds of the whole course with 40 Cy,then followed by isocenter hyperfractionated radiotherapy to keep away of spinal marrow, 1. 3-1. 5Gy per time,2 times a day and 5 days a week. The total dose was 60-66 Gy in A, B group and 60-70 Gy in C group. The preventive dose was 50 Gy. Results There was no statistically difference among the there groups on the short-term curative effect The 1- ,2- ,3-year local control rate was 80% ,50.4% ,42.6% and 72.9% ,51.4% ,41. 1% and 63.1% ,38.5% ,30.8%
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Objective To evaluate the treatment results and side-reactions of esophageal carcinoma treated with late course accelerated hyperfration radiotherapy plus concurrent chemotherapy(LCAHR+C). Methods A prospective randomized trial was carried out on 173 esophagus squamous carcinoma patients whom were randomized into two groups:1. LCAHR group—89 patients treated by conventional fractionated radiotherapy during the first two-thirds of the whole course with 40Gy in 20-22 fractions, then followed by LCAHR with 20-30Gy in 14-20 fractions, 1.5Gy per fraction, 2 times per day, to a total dose of 60-70Gy in 34-42 fractions over 37-42 days; 2.LCAHR+C group—94 patients were received the same radiotherapy as LCAHR, supplement with concurrent chemotherapy from the first day of radiotherapy. The chemotherapy regimen was LFP: intravenous infusion of cisplatin 20mg/d, calcium folinate 100mg/d and 5-fluorouracil 500mg/d for five consecutive days, every 28d as one cycle to totally 4 cycles. Results The short-term effective rate was 85% and 95% in LCAHR and LCAHR+C group,respectively(?~2=4.45,P=0.035).The 1-,2-and 3-year local control rate was 73%,55%,49% and 83%,73%,65% in LCAHR and LCAHR+C group, respectively(?~2=5.32,P=0.021).The 1-,2- and 3-year survival rate was 74%,53%,41% and 84%,65%,52% in LCAHR and LCAHR+C group,respectively(?~2= 2.85 , P= 0.091 ).The leucocytopenia and gastrointestinal tract side-reactions in LCAHR+C group were more severe than those of LCAHR group(?~2=7.85,15.06;P=0.005,0.000). Conclusions Late course accelerated hyperfractionated radiotherapy plus concurrent chemotherapy can be taken as a effective treatment for esophageal carcinoma. It can improve short-term curative effect and local control rate, in spite of increase in leucocytopenia and gastrointestinal tract side-reactions.
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0.05). The incidence of acute esophagitis was increased but it was acceptable in the LACF group (P
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Objective To analyze the result of late course accelerated hyperfractionation (LCAFR) and three dimensional conformal radiotherapy plus concurrent chemotherapy (LCAFR+C)on stage Ⅲ esophageal carcinoma. Methods Ninety-eight patients with stage Ⅲ esophageal carcinoma were divided randomly into two groups:1. LCAFR group: patients were treated with conventional fractionated radiotherapy during the first two-thirds of the treatment to a dose of 40?Gy in 20 fractions over 4 weeks, then followed by LCAFR with reduced fields using three dimensional conformal radiotherapy to a dose of 15-24?Gy over 7-12 days, 1.5Gy per fraction, to the total dose of 55-64?Gy in 30～36 fractions over 35-40 days. 2. LCAFR+C group:The radiotherapy schedule was the same as the LCAFR group,but with concurrent chemotherapy of DDP 20?mg d1-5, LF 200?mg and 5-Fu 500?mg d 6-10 , 28 days in one cycle to totally 5 cycles. Results The 1-, 2-, and 3-year actuarial survival rates were 73%, 53%, 35% and 76%, 73%, 55% respectively (? 2=4.12,P
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Objective To compare the treatment effects and toxicity of late co urse accelerated hyperfractionation radiotherapy (LCAFR), LCAFR plus concurren t chemotherapy (LCAFR+C) and conventional fractionation radiotherapy(CFR) on esop hageal cancer. Methods 150 patients with squamous carcinoma of thoracic esophag us were divided randomly into three groups: 1.CFR group, patients were irradiate d 2.0?Gy/f, 5 times a week, to a total does of 60?Gy. 2. LCAFR group, patients wer e first irradiated with CFR to 30?Gy, then followed by 1.5?Gy/f bid, at more t han 6 hours' interval, to the total dose of 60?Gy. 3.LCAFR+C group: The radiotherap y technique was the same as the LCAFR group, but weekly 20 mg DDP and 500 mg 5-Fu wer e added simultaneously for 5 weeks. Results All three groups completed their tre atment course. Of CFR, LCAFR and LCAFR+C groups, the 1-,2-,3- and 4-year sur viva l rates were 54%, 30%, 18%, 18%; 76%, 56%, 44%, 42% and 82%, 62%, 50%, 44%. The 1-,2-,3- and 4-year local control rates were 40%, 32%, 26%, 24%; 72%, 60%, 5 6%, 54% and 78%, 66%, 60%, 56%, with obvious better results in the latter two groups (P0.05). The acute toxic effect was severer in the LCAFR+C g roup than in the other two, with the difference significant between the LCAFR+C and CFR group, bu t not between the LCAFR and CFR group. The tolerance of the patients to LCAFR wa s better than that of LCAFR+C group. There were no significant differences in la te complications and causes of death between the three groups. The main cause of death was local recurrence and uncontrolled primary disease, which were signifi cantly lower in the LCAFR and LCAFR+C groups than in the CFR group. Conclusions Both late course accelerated hyperfractionation radiotherapy and late course acc elera ted hyperfractionation radiotherapy plus chemotherapy can significantly improve the local control and survival of esophageal cancer, but the latter has increase d toxicity. Concurrent small dose chemotherapy can not lowered the remote metas tatic rate.