胸上段颈段食管鳞癌调强放疗疗效观察.docVIP

胸上段颈段食管鳞癌调强放疗疗效观察 　　作者：王文高,闫爱云,王琍,魏子祥,王多为　　作者单位：淮南东方医院集团肿瘤医院放疗中心 　　【摘要】 目的 分析调强放疗和常规放疗对胸上段颈段食管鳞癌局部控制、生存情况及放射性损伤。方法 46例患者随机分成2组，调强治疗组26例，使用拓能公司Venus调强放疗计划系统，5～7野动态调强，2.0～2.4 Gy/次，5次/周，TD：60～66 Gy;常规治疗组20例，2.0 Gy/次，5次/周，TD：60～66 Gy。结果 1年局部控制率调强组和常规组分别为65.38%(17/26)60%(12/20)，Χ2=0.1407,P0.05;3年局部控制率分别为53.85%(14/26);40.0%(8/20)，Χ2=0.8685，P0.05,两组1-3年生存率分别为：61.54%(16/26)，46.15%(12/26)和55%(11/20)，35%(7/20);卡方值分别为Χ2=0.1993、0.5801，P值均大于0.05。 两组放射性食管炎差异无统计学意义;二级以上放射性肺炎调强组和常规组分别为7.69%(2/26);45%(9/20);Χ2=8.648，P0.05。结论 调强放疗与常规放疗相比，局部控制和生存稍有优势，而二级以上放射性肺损伤明显减少。 　　【关键词】 食管癌;调强放疗 　　Intensity modulated radiotherapy or convention fraction radiotherapy for cervical and upper thoracic esophageal squamous cell carcinoma Wang Wengao,Yan Aiyun,Wang Li,et al Department of Radiation Onconogy Tumor Hospital of Huainan East General Hospitals,Huainan 232035 　　[Abstract]Objective Compare the local control rates the survival rates and toxicity of IMRT or CRF.Methods Forty-six patients were divided into two groups: The IMRT group (26): venus-TPS of Tolane Company .5-7fields sliding IMRT; 2.0-2.4 Gy/f, 5f/w, TD; 60-66 Gy and the CFR group(20)， 2.0 Gy/f,5f/w,TD; 60-66 Gy. Results The 1-year local control rates of IMRT and CFR was 65.38%(17/26)，60%(12/20)，Χ2=0.1407，P0.05;The 3-year local control rates of IMRT and CFR was 53.85%(14/26), 40%(8/20),Χ2=0.8685,P0.05; The 1-year survival rates of IMRT and CFR was 61.54%(16/26),55.00%(11/20);Χ2=0.1993,P0.05. The 3-year survival rates of IMRT and CFR was 46.15%(12/26), 35%(7/20),Χ2=0.5801，P0.05. There are no significant differences in acute or late esophagitis rate between the both groups but highter grade 2-4 acute radiation pneumonitis rates were highter in CFR,IMRT and CFR was 7.69%(2/26)，45%(9/20), Χ2=8.648,P0.05. Conclusion The local control rate, the survival rate was better in the IMRT group than CFR group. The higher grade 2-4acute radiation pneumonitis rates were more severe in the CFR group than the IMRT group. The IMRT will be a