影响食管癌放射治疗近期疗效的大体肿瘤因素分析  

Gross tumor-related factors that influence the response of esophageal carcinoma to radiotherapy

作　　者：陈明秋[1] 林庆良[1] 张莹莹[1] 卢赠华[2] 徐本华[1] 

机构地区：[1]福建医科大学协和临床学院福建医科大学附属协和医院放疗科,福州350001 [2]福建医科大学协和临床学院福建医科大学附属协和医院放射科CT/MR室,福州350001

出　　处：《癌症进展》2009年第6期648-653,共6页Oncology Progress

基　　金：福建省科技厅青年科技人才创新项目(项目编号:2005J042)

摘　　要：目的讨论食管癌肿瘤体积、长度、最大径对放射治疗及同步放化疗近期疗效的影响。方法回顾性分析2006年5月～2008年8月在我科就诊的食管癌患者47例,其中行单纯放疗者25例,行同步放化疗者22例。在治疗前、治疗结束时及结束后4周分别采取相同体位进行定位CT(CT-sim)扫描,由一位有经验的放射治疗科医师和一位影像科医师共同在CT-sim图像上进行肿瘤勾画,通过治疗计划系统(TPS)测算出每例病人肿瘤体积、长度及最大径,采用RECIST标准进行近期疗效评价。分析肿瘤体积、长度及最大径与食管癌放射治疗后近期疗效的关系,并在单纯放疗组与同步放化疗组间进行对比分析。结果47例患者治疗前肿瘤体积在6.9～317.53 cm^3之间(中位值58.28cm^3),长度在3.0～18.5cm之间(中位值8.00cm),最大径在1.5～8.0cm之间(中位值4.40cm);治疗前肿瘤体积、长度、最大径与食管癌近期疗效存在负相关性(P值分别为:0.000;0.000;0.001)。在单纯放疗组,长度与近期疗效无相关性(P=0.102);在放化疗组,最大径与近期疗效无相关性(P=0.069)。结论食管癌肿瘤体积、长度及最大径是影响放疗近期疗效重要因素,最大径与单纯放疗近期疗效关系密切,但与同步放化疗近期疗效无明显相关性。Objective To investigate the influence of volume, length and maximum diameter of the gross tumors on the short-term response of radiotherapy and concurrent ehemo-radiotherapy （CCRT） for esophageal carcinoma. Methods Forty-seven newly diagnosed esophageal carcinoma patients from May, 2006 to August, 2008 were included in this retrospective study. Among them 25 patients received radiotherapy alone and 22 patiemts received CCRT. All patients underwent CT scan with a same position before treatment, immediate after treatment, and 4 weeks after treatment. The gross tumor was delineated with a radiation oncologist and a radiologist separately on these 3 CT scans. The volume, length and maximum diameter of tumor were measured on the treatment planning system （TPS）. The influences of volume, length and maximum diameter of tumor on the short-term response were analyzed, and the outcomes of the radiotherapy alone and CCRT group were compared. Results The median tumor volume was 58. 28cm^ 3 （range 6. 9 - 317. 53cm^ 3 ）, the median length was 8. 00cm （3. 0 -18. 5cm） and the median maximum diameter was 4. 40cm （1.5 -8. 0cm）. The tumor volume, length, and maximum diameter were significantly correlated with the short-term response （P values： 0. 000, 0. 000, 0. 001, respectively）. In contrast, the correlation between the length and the short-term response was not significant （P =0. 102） in the radiotherapy alone group, and the correlation between maximum diameter and the short-term response was not significant （P =0. 069） in the CCRT group. Conclusion The tumor volume, length, and maximum diameter of esophageal tumor in general are important factors that influence the short-term response of radiotherapy. The maximum diameter may influence the short-term response in the radiotherapy alone group, but not in the CCRT group.

关 键 词：食管肿瘤 大体肿瘤 放射疗法 同步放化疗 疗效 

分 类 号：R735.1[医药卫生—肿瘤]