三维适形放射治疗食管癌75例临床疗效分析  

Three Dimensional Conformal Radiation-Therapy for Esophageal Carcinoma

作　　者：王承伟[1] 吴霞[1] 祝玲[1] 

机构地区：[1]镇江市第一人民医院放射治疗中心,江苏镇江212002

出　　处：《肿瘤基础与临床》2007年第2期154-156,共3页journal of basic and clinical oncology

摘　　要：目的探讨三维适形放射治疗(3DCRT)食管癌的疗效及放射治疗反应。方法采用3DCRT方法治疗食管癌75例(3DCRT组,2.5-3.0 Gy/次,1次/d,共20-22次,总剂量60 Gy,25-30 d),与同期行常规放射治疗的75例食管癌(CF组,2.0 Gy/次,5次/周,64-68 Gy,44-48 d)进行比较。结果CF组和3DCRT组1,2,3,4年局部控制率分别为55.6%,41.8%,32.9%,24.9%,和72.6%,63.6%,50.1%,43.1%(P=0.011)。CF组和3DCRT组放射治疗后1,2,3,4年生存率分别为48.7%,41.5%,30.5%,21.8%,和63.2%,52.2%,44.1%,38.7%,(P=0.027)。3DCRT组放射性食管炎发生率较CF组高(P=0.003),血液系统及全身反应3DCRT组较CF组轻(P=0.007,P=0.021)。结论3DCRT能明显改善食管癌的局部控制率和生存率,近期放射反应及远期放射损伤均可耐受。Objective To evaluate the results and side effects in three dimensional conformal radiation therapy （3DCRT） for esophageal carcinoma. Methods From December 2000 to December 2001,75 patients with esophageal carcinoma were treated with 3DCRT （3DCRT group） , in which all the case were treated once every day to a total dose of 60 Gy in 25 - 30 days at 2.5 - 3.0 Gy per fraction totally 20 - 22 fractions, and during the same period, other 75 patients treated by conventional fractionation radiotherapy （CF group） to a total dose of 64 68 Gy over 44 -48 days at 2.0Gy per fraction 5 days per week were analyzed and compared. Results The 1-,2-,3- and 4-year local control rates in 3DCRT group were 72.6% ,63.6% ,50.1% and 43.1% ,compared with 55.6% ,41.8% ,32.9% and 24.9% in CF group（ P = 0.011 ）. And the survival rates in 1-,2-,3- and 4-years in 3DCRT group were 63.2% , 52.2% ,44. 1% and 38.7% , as compared with 48.7%,41.5%,30.5% and 21.8% in CF group（P=0.027）.However, in the3DCRT group, the incidence of acute radiation esophagitis was higher （ P = 0. 003 ） and those of hematogenous side effects and B symptom were lower （ P = 0. 007, P = 0.021 ）. Conclusions Compared with conventional fraetionation radiotherapy,3DCRT was able to improve the local control rate of esophageal carcinoma, with tolerable acute and late radiation side effects.

关 键 词：食管肿瘤 放射治疗 适形 预后 

分 类 号：R730.55[医药卫生—肿瘤] R735.1[医药卫生—临床医学]