容积调强与固定野动态调强以及适形放疗治疗食管癌的临床疗效比较  

Efficacy Comparison of the Volume Intensity Modulation, Fixed Field Intensity, and Conformal Radiotherapy for Treatment of Esophageal Cancer Patients

作　　者：胡翔 章龙珍 丁纪[2] 郝大为 吴承骏[2] HU Xiang;ZHANG Longzhen;DING Ji;HAO Dawei;WU Chengjun(Graduate School, Xuzhou Medical University, Jiangsu, Xuzhou, 221009, China;Department of Radiation Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu, 221009, China)

机构地区：[1]徐州医科大学研究生学院,江苏徐州221009 [2]徐州市中心医院放疗科,江苏徐州221009

出　　处：《肿瘤药学》2017年第5期591-595,618,共6页Anti-Tumor Pharmacy

摘　　要：目的探讨容积调强、固定野动态调强以及适形放疗对上段食管癌的临床疗效,为临床治疗提高参考。方法选取我院2012年3月~2014年9月收治的53例上段食管癌患者为研究对象,均采取相同的放疗计划系统,随机分为Rapid Arc组20例、DIMRT组17例和适形放疗组16例,并采用计量体积直方图分析计量和危及气管计量。结果 GTV剂量分布上,Rapid Arc组的Dmax、CI明显高于其他两组,HI明显低于其他两组,差异均有统计学意义(P<0.05);PTV剂量分布上,Rapid Arc组的Dmax低于DIMRT组、高于适形放疗组,Dmin、V95、HI明显低于其他两组,CI明显高于其他两组,差异均有统计学意义(P<0.05)。Rapid Arc组、DIMRT组患者的肺V5、V10、V20、心V30、V40、脊髓D01均显著低于适形放疗组,Rapid Arc组、适形放疗组患者的肺Dmean、心Dmean均显著低于DIMRT组,差异均有统计学意义(P<0.05)。Rapid Arc组的机器跳数、有效治疗时间、γ通过率明显小于DIMRT组,DIMRT组的机器跳数、有效治疗时间、γ通过率明显小于适形放疗组,差异均有统计学意义(P<0.05)。Rapid Arc组患者不良反应发生率明显低于DIMRT组和适形放疗组,差异有统计学意义(P<0.05)。治疗后三组肿块均较治疗前缩小,其中Rapid Arc组肿块体积最小,适形放疗组肿块体积最大,组间差异有统计学意义(P<0.05)。结论 Rapid Arc、DIMRT技术和适形放疗均可应用于上段食管癌患者的放疗,且Rapid Arc、DIMRT技术的临床优势更明显。Objective To investigate the effects of volume intensity modulation,fixed field intensity,and conformal radiation therapy onpatients with upper esophageal carcinoma,and to improve the clinical treatment.Methods53patients with upper esophageal carcinomawere collected as the research objects between March2012and September2014in our hospital.They were divided into three groups accordingto the same radiotherapy planning system.There were20cases in RapidArc group,17cases in DIMRT group,and16cases in conformalradiotherapy group.The dose volume and tracheal crisis were analyzed by histogram.Results In the dose distribution of GTV of theRapidArc group,Dmax and CI were significantly higher than those of the other two groups,but HI was significantly lower than those of theother two groups.In the PTV dose distribution of the RapidArc group,Dmax was lower than that of the DIMRT group,but higher than thatof the conformal radiotherapy group.Dmin,V95%and HI were significantly lower than those of the other two groups.CI was significantlyhigher than that of the other two groups.In GTV dose distribution of RapidArc group,Dmax,HI and CI were significantly different from theother two groups.In PTV dose distribution of RapidArc group,Dmax,Dmin,V95%,HI and CI were significantly different from the other twogroups.In spinal cord of the heart in conformal radiotherapy group,V10V20,lung V5,V30,V40and D01were significantly lower than that of RapidArc group.The pulmonary heart Dmean in conformal radiotherapy group was significantly lower than in DIMRT group.The machinehops,effective treatment time,and gamma pass rate of the RapidArc group were less than those of the DIMRT group.In DIMRT group,themachine hops,effective treatment time,and the rate of gamma irradiation were significantly less than in the radiotherapy group.The incidenceof adverse reactions in RapidArc group was significantly lower than in the other two groups,and the difference was statistically significant(P<0.05).After treatment,tumor size in all the three groups was smaller

关 键 词：食管癌 容积调强 固定野动态调强 适形放疗 

分 类 号：R735.1[医药卫生—肿瘤]