PhaseⅢstudy on late course accelerated fractionated irradiation combined with concurrent chemotherapy for esophagus squamous cell carcinoma / 中华放射肿瘤学杂志

ABSTRACT

Objective To evaluate the role of late course accelerated fractions.ted irradiation(LCAF) combined with concurrent chemotherapy in the management of esophageal carcinoma.Methods From March 1998 to July 2000,111 eligible patients were randomized into LCAF alone group(LCAF,57 patients)or LCAF plus concurrent chemotherapy group(LACF-CT,54 patients).The radiotherapy regimen was identical in the two groups,consisting of conventional fractionation in the first 2/3 course and accelerated fractionation in the second 1/ 3 course to a total dose of 68.4 Gy/41 Fx/44 d.Chemotherapy regimen consisted of four eycles of cisplatin 25 mg/ (m~2?d)plus fluorouracil 600 mg/(m~2?d)on day 1 to 3 every 4 weeks and was delivered on the first day of radiotherapy.Results The median follow-up time was 67.1 months(range 47.6-76.4 months).The 1-,3-,5- year survival rate was 67%,44% ,40% and 77%,39% 28% in LACF-CF and LEAF group,respectively(P =0.310).Grade 3+4 acute side-effact was 42% and 25% in LCAF-CT and LCAF group,respectively(P＜0. 05),with 3 treatment-related deaths in the LCAF-CT group.Conclusions Late course accelerated fractionated irradiation combined with concurrent chemotherapy has a trend towards improving the survival,at the cost of increasing acute side-effect.Its role needs further confirmation by larger sample studied in randomization.