Whole course accelerated hyperfractionation radiotherapy for esophageal carcinoma / 中华放射肿瘤学杂志

ABSTRACT

Objective To compare the treatment effects and toxicity of convention fractionation ra- diotherapy(CFR),late course accelerated hyperfractionafion radiotherapy(LCAFR) and whole course accel- erated hyperfractionation radiotherapy(WCAFR) for patients with middle or low thoracic esophageal moder- ately differentiated squamous cell carcinoma.Methods Ninety patients with middle or low thoratic esoph- ageal carcinoma were divided into three groups1.CFR group,patients were irradiated 2.0 Gy/f,5 times a week,to a total dose of 70 Gy;2.LCAFR group,patients were first irradiated with CFR to 40 Gy,then fol- lowed by 1.5 Gy/f bid,at more than 6 hoursinterval,5 times a week,to a total dose of 70 Gy;3.WCAFR group,patients were irradiated 1.5 Gy/f bid,at more than 6 hoursinterval,5 times a week,to a total dose of 72 Gy.Results The 1-,2-,3-year local control rate was 47%,17% and 0% in CFR group,60%,20% and 20% in LCAFR group,60%,40% and 33% in WCAFR group,respectively.The 1-,2-,3-year survival rate was 47%,20% and 10% in CFR group,63%,43% and 17% in LCAFR group,and 63% ,50% and 33% in WCAFR group,respectively.There were better results in the latter two groups(P＜0.01).The a- cute toxic effect was severer in the WCAHF and LCAF groups than in CF group.Highter grade 2-3 acute esophagitis rate was observed both in WCAHF and LCAF groups.There were no significant differences in late esophagitis rate between the three groups.The grade 1-2 acute radiation pneumonitis rates were higher in WCAHF group than in LCAF and CF groups.One patient died of radiation pneumonitis in WCAHF group. Conclusions Whole course accelerated hyperfractionation radiotherapy can significantly improve the local control rates and the 1-and 2-year survival rates of esophageal cancer,but can also increase the toxicity.