老年食管癌67例患者的临床特征和调强放疗的疗效观察  

Clinical features of 67 elderly patients with esophageal cancer and the therapeutic effects of intensity-modulated radiotherapy

作　　者：马建华[1] 尚玉萍[1] 王忠明[1] 陈程[1] 杨云云[1] 刘宝玲[1] 屠婷婷[1] 

机构地区：[1]连云港市第二人民医院放疗科,连云港222000

出　　处：《山西医科大学学报》2016年第11期1005-1007,共3页Journal of Shanxi Medical University

摘　　要：目的探讨70岁以上老年食管癌的临床特征、调强放疗的近期疗效。方法回顾性分析2015-03～2016-03我院放疗科收治的67例70岁以上老年食管癌的临床资料,包括首发症状、患者相关性延迟诊断、病变部位、病理特征、病变长度、临床分期、近期疗效和不良反应等。全组病例均采用调强放疗,处方剂量为50-60 Gy,单次剂量为1.8-2.0 Gy;观察近期疗效和毒副反应。结果 67例患者首发症状为进食梗阻,占88.1%;患者相关性延迟诊断〉2个月占61.2%;病变部位为胸中段占59.7%;鳞癌占89.5%;病变长度〉5 cm占71.6%;Ⅱ和Ⅲ期占89.5%;有心肺等基础疾病的占59.7%。64例患者按处方剂量完成放疗,完成率为95.5%,其中CR 9例（14.1%）,PR 48例（75.0%）,NR 7例（10.9%）,有效率89.1%。急性放射性肺炎的发生率为22.4%,放射性食管炎的发生率为100%,白细胞减少的发生率为11.9%,全部为1、2级不良反应。结论老年食管癌主要以进食梗阻为首发症状,患者相关性延迟诊断时间较长,病变部位以胸中段常见,病理类型以鳞癌为主,病变长度〉5 cm占大多数,临床分期以Ⅱ和Ⅲ期为主,绝大多数有心肺等基础疾病。调强放疗的近期疗效可,耐受性好,是老年食管癌主要的治疗手段。Objective To review the clinical features of elderly patients with esophageal cancer and investigate therapeutic effects of intensity-modulated radiotherapy（ IMRT）. Methods Clinical data of 67 elderly patients with esophageal cancer over 70 years old admitted to Second People＇S Hospital of Lianyungang from March 2015 to March 2016 were retrospectively reviewed,including their first symptom,patient-related delay in diagnosis（ PRDD）,lesion site,pathological features,lesion extent,clinical stage,short term effect and adverse reaction. All the patients received IMRT,DT 50- 60 Gy,1. 8- 2. 0 Gy / f. Results In the 67 cases,the patients with the incidence of dysphagia as first symptom,PRDD〉 2 months,midthoracic esophagus,squamous cell carcinoma,lesion extent,stage Ⅱor Ⅲ,or other conditions such as heart or pulmonary diseases accounted for 88. 1%,61. 7%,59. 7%,89. 5%,71. 6%,89. 5% and 59. 7%,respectively. A total of 64 patients（ 95. 5%） completed the prescription dose,including 9 cases（ 14. 1%） of CR,48 cases（ 75. 0%） of PR and 7 cases（ 10. 9%） of NR,and the effective rate was 89. 1%. Incidence of radioactive pneumonia,radioactive esophagitis,and myelosuppression was 22. 4%,100% and 11. 9%,respectively. Conclusion The main first symptom of elderly patients with esophageal cancer is dysphagia with long PRDD. Midthoracic and squamous cell esophagus is common. Most of them are at stage Ⅱor Ⅲ,with lesion extent 〉5 cm and other diseases such as heart or pulmonary diseases. Intensity-modulated radiotherapy is a safe and effective therapy for esophageal cancer.

关 键 词：食管癌 临床特征 调强放疗 老年人 

分 类 号：R735.1[医药卫生—肿瘤]