调强放疗或三维适形放疗联合同步化疗在治疗局部中晚期食管癌中的应用  

The application of intensity modulated radiation therapy or three-dimensional conformal radiotherapy combined with concurrent chemotherapy in the treatment of local moderate and advanced esophageal cancer

作　　者：冯梓贤 吴培信 王晓亮[1] 钟美霞[1] 陈广杰[1] 

机构地区：[1]广东省廉江市人民医院肿瘤科,广东廉江524400 [2]广东省廉江市人民医院普通外科,广东廉江524400

出　　处：《广东医学院学报》2016年第6期618-621,共4页Journal of Guangdong Medical College

基　　金：湛江市科技攻关计划项目(No.2016B01069)

摘　　要：目的探讨调强放疗(IMRT)或三维适形放疗(3DCRT)联合同步化疗在治疗局部中晚期食管癌中的应用。方法将76例的中晚期食管癌患者分为实验组(36例)与对照组(40例),实验组采用IMRT联合同步化疗方案治疗,对照组采用3DCRT联合同步化疗方案治疗。统计并分析两组的疗效、死亡原因和不良反应。结果实验组的3 a局部控制率高于对照组(P<0.05);因肿瘤局部因素而死亡的患者构成比以及骨髓抑制的发生率明显低于对照组(均P<0.05);放射性肺炎的发生率则高于对照组(P<0.05)。结论与3DCRT联合同步化疗方案相比,IMRT联合同步化疗方案有较好的局部控制率,并且可明显降低骨髓抑制发病率,但放射性肺炎发病率高。Objective To investigate the application of intensity modulated radiation therapy （IMRT） or three-dimensional conformal radiotherapy （3DCRT） combined with concurrent chemotherapy in the treatment of local moderate and advanced esophageal cancer. Methods 76 patients with local moderate and advanced esophageal cancer were divided into Experimental Group （36 cases） and Control Group （40 cases）. Experimental Group received the treatment with was IMRT combined with concurrent chemotherapy while Control Group received the treatment with 3DCRT combined with concurrent chemotherapy. Data was collected and analyzed on the curative effect, cause of death and adverse reactions. Results The 3 year local control rate in Experimental Group was significantly higher than that in Control Group （P〈0.05）. The total constituent ratio of the patient who died due to local factors of cancer and the incidence of myelosuppression in Experimental Group was significantly lower than that in Control Group （P〈0.05）. The incidence of radiation pneumonia in Experimental Group was significantly higher than that in Control Group （P〈0.05）. Conclusions Compared with 3DCRT combined with concurrent chemotherapy treatment, IMRT combined with synchronous chemotherapy treatment has a better local control rate and can significantly reduce the incidence of bone marrow suppression, but has a higher incidence of radiation pneumonia.

关 键 词：食管癌 调强放疗 三维适形放疗 疗效 不良反应 死亡原因 

分 类 号：R735.1[医药卫生—肿瘤]