食管癌三维适形放疗疗效观察  

Three-dimensional Conformal Radiotherapy for Esophageal Carcinoma

作　　者：王澜[1] 韩春[1] 张辛[1] 王军[1] 肖爱勤[1] 麻国新[1] 

机构地区：[1]河北医科大学第四医院放疗科,石家庄市050011

出　　处：《中国肿瘤临床》2008年第8期424-427,共4页Chinese Journal of Clinical Oncology

基　　金：河北省普通高校强势特色学科课题基金资助(编号:200552)

摘　　要：目的:观察食管癌三维适形放疗的疗效及急性毒副反应。方法:2003年7月至2007年3月,100例首程治疗的食管癌患者接受三维适形放射治疗,全组处方剂量5600～7000cGy,中位处方剂量6400cGy,200cGy/次,1次/天,5次/周。对其疗效及急性毒副反应进行评价。结果:1)全组患者完全缓解(CR)65例(65.00%),部分缓解(PR)34例(34.00%),无缓解(NR)1例,肿瘤总有效率(CR+PR)为99.00%。2)1、2、3年局部控制率分别为73.49%、55.21%、42.77%,1、2、3年总生存率分别为73.25%、48.09%、43.39%,中位生存期24个月,多因素分析显示主动脉受侵和近期疗效为强相关因素。全组合并主动脉受侵者42例,未合并主动脉受侵者58例,3年生存率分别为35.25%和48.26%,P=0.0577。放疗后近期疗效达CR者65例,PR者34例,3年生存率分别为50.27%和31.08%,P=0.0163。3)急性放射性肺炎0级51例(51.00%),1级27例(27.00%),2级16例(16.00%),3级6例(6.00%),无4级发生;急性放射性食管炎0级18例(18.00%),1级50例(50.00%),2级24例(24.00%),3级8例(8.00%),无4级发生。结论:三维适形放疗是治疗食管癌的有效手段,有提高患者生存率的趋势,其远期疗效有待进一步观察。Objective： To observe the clinical results and acute side effects of three-dimensional conformal radiotherapy （3DCRT） for esophageal carcinoma. Methods： From July 2003 to March 2007, 100 patients with esophageal carcinoma received 3DCRT with a median prescription dose of 6400eGy （ranging from 5600eGy to 7000eGy）, 200 eGy/per fraction, 1 fraction/per day, 5 factions/per week. The clinical results and side effects were evaluated. Results： （1）Sixty-five patients had eomplete remission（CR）, and 34 patients had partial remission（PR）. The overall response rate was 99% （CR＋PR）. （2） The 1-. 2-, and 3-year local control rates were 73.49%, 55.21% and 42.77%, respe（qively. The 1-, 2-, and 3-year overall survival rates were 73.25%, 48.09% and 43.39%, respectively. The median survival time was 24 months. Multivariate analysis showed that aortic invasion and short term results were correlation factors. Aortic invasion was observed in 42 patients. The 3-year survival rate was 35.25% in patients with aortic invasion, and 48.26% in patients without aortic invasion. respectively （P=0.0577）. A total of 65 patients had CR and 34 patients had PR after radiotherapy, with a 3-year survival rate of 50.27% and 31.08%, respectively（P=0.016 3）. （3） Of these 100 patients, 49（49%） developed radiation pneumonitis（RP）： grade 1 in 27 patients, grade 2 in 16 patients and grade 3 in 6 patients. Acute radiation esophagitis was also observed： grade 0 in 18 patients, grade 1 in 50 patients, grade 2 in 24 patients and grade 3 in 8 patients. Conclusion： The technique of 3DCRT is an effective treatment for esophageal carcinoma and can improve the overall survival rate. Further studies should use a larger population and a longer follow-up to identify the long term effect of 3DCRT.

关 键 词：食管肿瘤 放射治疗 适形 生存率 

分 类 号：R735.1[医药卫生—肿瘤]