First course concurrent chemotherapy and late course accelerated hyperfractionation radiotherapy on esophageal carcinoma.

Objective To compare the treatment effects and toxicity of late course accelerated hyperfractionation radiotherapy(LCAF),first course concurrent chemotherapy plus LCAF(C+LCAF) and conventional fractionation radiotherapy(CF) on esophageal cancer.Methods A totol of 90 patients with squamous carcinoma of thoracic esophagus were divided randomly into three groups.CF group: patients were irradiated 2.0Gy/f,5 times a week,to a total dose of 64Gy.LCAF group: patients were first irradiated with CF to 40Gy,then followed by 1.5Gy/f bid,at more than 6 hours' interval,to the total dose of 64Gy.C+LCAF group: patients were first irradiated with CF plus weekly 40mg DDP and 1000mg 5-Fu for 4 weeks,then used LCAF.Results All three groups completed treatment course.Of CF,LCAF and C+LCAF groups,the 1-,2-and 3-year survival rates were 53%,30%,20%;80%,60%,47% and 83 %,67%,53%.The 1-,2-and 3-year local control rates were 43%,33%,23%; 77%,63%,57% and 80%,73%,57%,with obvious better results in the latter two groups(P0.01),though without any statistical difference between the latter two groups(P0.05).The acute toxic effect was severer in the C+LCAF group than in the other two,with the signficant difference between the C+LCAF and CF group,but not between the LCAF and CF group.There were no significant differences in late complications between the three groups.Conclusion Both LCAF and C+LCAF can significautly improve the local control rates and survival rates of esophageal cancer,but the latter has increased toxicity.