根治性放疗后局部复发的食管癌再程放疗的临床研究  

Clinical Study of Recurrent Esophageal Carcinoma After Radical Radiotherapy

作　　者：王志伟[1] 侯欣[1] 时磊[1] 谢萱虎[1] 孙萍[1] 段永建[1] 

机构地区：[1]河南大学第一附属医院,河南开封475000

出　　处：《深圳中西医结合杂志》2017年第7期8-9,共2页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:观察根治性放疗后局部复发的食管癌再程放疗的临床效果。方法:选取2012年11月至2013年11月河南大学第一附属医院接收的90例根治性放疗后复发的食管癌患者,实施再程放疗,每次1.8~2.0 Gy,每周5次。照射剂量结合患者实际情况而定。总剂量为45~60 Gy。结果:84例患者顺利完成治疗,完全缓解(CR)16例,部分缓解(PR)54例,疾病稳定(SD)14例。Ⅱ级放射性食管炎者36例,Ⅲ级放射性食管炎者4例。14例为Ⅱ级放射性肺炎,2例为Ⅲ级放射性肺炎。死亡74例,10例病患在治疗后3个月发生食管穿孔,5个月后病死。6例因全身恶化。2例在接受治疗后因肺部出血病死,病死于肺部感染者共计6例,心衰8例,呼吸衰竭10例。内科合并症为12例。恶性病变20例。患者的1年和2年生存率为40%和18%。CR者生存时间均在2年以上,1年和2年生存率比较,差异具有统计学意义(P<0.05)。结论:对于放疗后复发食管癌患者,实施再程放疗技术,可全面改善临床症状,提升患者生活品质,近期效果较好,远期治疗结果尚待进一步探析。Objective To investigate the clinical effect of local recurrence of esophageal carcinoma after radical radiotherapy. Methods 90 cases of recurrence after radical radiotherapy of esophageal cancer patients from November 2012 to November 2013 selected in our hospital received as the research object, the implementation of reradiotheraphy, 1.8 - 2.0 Gy/times, 5 times/week. Exposure dose in combination with the patient＇s actual condition. The total dose was 45 - 60 Gy. [Results 84 patients successfully completed treatment, CR （complete remission） in 16 cases, PR （partial remission） in 54 cases, SP （stable disease） in 14 cases. Grade II radioactive esophagitis in 36 cases, III grade radioactive esophagitis in 4 cases. 14 cases of grade II radioactive pneumonia, 2 cases of grade III radioactive pneumonia. 74 cases died, 10 patients occurred 3 months after treatment occurred esophageal perforation, 5 months after the death. 6 cases due to systemic deterioration. 2 cases were treated with pulmonary hemorrhage after treatment, died of pulmonary infection in a total of 6 cases, 8 cases of heart failure, respiratory failure in 10 cases. Internal medical complications in 12 cases. Malignant lesions in 20 cases. The 1-year and 2-year survival rates were 40 % and 18 % for patients. The survival time of CR was more than 2 years, and there was significant difference between one year and two years （P 〈0.05）. Conclusion For patients with recurrent esophageal cancer after radiotherapy, the implementation of reradiotheraphy technology, can improve clinical symptoms, improve the quality of life of patients, long-term treatment results still need further research.

关 键 词：根治性放疗 局部复发 食管癌 再程放疗 

分 类 号：R735.1[医药卫生—肿瘤]