三维适形放疗联合同期化疗治疗食管多发癌的临床观察  

Clinical observation on three-dimensional conformal radiotherapy combined with concurrent chemotherapy in the treatment of multiple primary carcinoma of esophagus

作　　者：陈意标[1] 张汉雄[1] 蒋振东[1] 刘挺[1] 朱文标[2] 邓国明[3] 

机构地区：[1]广东省梅州市人民医院放疗二科,514031 [2]广东省梅州市人民医院病理科,514031 [3]广东省梅州市人民医院肿瘤外一科,514031

出　　处：《肿瘤研究与临床》2013年第1期22-24,共3页Cancer Research and Clinic

摘　　要：目的 分析食管多发癌三维适形放疗联合同期化疗的疗效及患者不良反应。方法 收集15例拒绝手术治疗的食管多发癌患者，采用直线加速器6 MV／10 MV X线分3～4个共面野进行适形照射，2 Gy／次，1次／d，5次／周；临床靶区剂量40～50 Gy／4～5周，肿瘤靶区剂量60 Gy／6周；同期采用TP方案（紫杉醇＋顺铂）第1、29天联合化疗；化疗后第2天开始行三维适形放疗。结果 所有患者1、3年局部控制率和总生存率分别为86.7 %（13／15）、33.4 %（5／15）和73.3 %（11／15）、26.6 %（4／15）。不良反应：1～2级、3～4级急性放射性食管炎和白细胞减少症发生率分别为86.7 %（13／15）、13.3 %（2／15）和80.0 %（12／15）、20.0 %（3／15）。结论 对于近端病灶位于胸上段甚至颈段的食管多发癌，放疗是较好的治疗手段；三维适形放疗联合同期化疗治疗食管多发癌的不良反应可耐受。Objective To analysis of the efficacy and toxicity of multiple primary cancer of esophagus in three-dimensional conformal radiotherapy and concomitant chemotherapy. Methods Fifteen cases of multiple primary carcinoma of esophagus who refused the operation were collected. The Elekta linac 6 MV/10 MV X ray was used to conformal irradiation in three-four coplanar wild, 2 Gy/ time, 1 time/day, 5 times/week. The dose to the target area, CTV 40-50 Gy/4-5 weeks, GTV 60 Gy/6 weeks. TP scheme （paclitaxel＋cisplatin） was used in the first day and 29th day, three-dimensional conformal radiation therapy initiated in the second day after chemotherapy. Results 1, 3 year local control and overall survival were 86.7 % （13/15）, 33.4 % （5/15） and 73.3 % （11/15）, 26.6 % （4/15）. Class 1-2 and class 3-4 acute radiation esophagitis and leukopenia occurred rates were 86.7 % （13/15）, 13.3 % （2/15） and 80 % （12/15）, 20 % （3/15）. Conclusion Radiation therapy is the better treatment method for multiple primary carcinoma of esophagus when proximal lesions located in upper thoracic and cervical high. Toxic and side-effects can be tolerated of three dimensional conformal radiation therapy combined with chemotherapy in the treatment of multiple esophageal cancer.

关 键 词：食管肿瘤 三维适形放疗 同期化疗 

分 类 号：R735.1[医药卫生—肿瘤]