放疗食管癌不同临床靶区的初步研究.pdfVIP

虫堡丝射耻疸堂盘查!Q!兰生i旦筮垫鲞筮!翅垦!也』垦型丝Q!!!!：丛!竺!!!!兰：!!!：望：盟!：! 三维技术放疗食管癌不同临床靶区的 初步研究 祝淑钗许金蕊 刘志坤 苏景伟 李娟 【摘要】 目的探讨食管癌淋巴引流区预防照射在根治性三维技术放疗中的价值，评价不同临 床靶区照射后疗效及不良反应。方法 回顾分析2005--2010年间219例无远处转移的行根治性三 维技术放疗的食管癌患者资料。105例接受累及野照射54～66 Gy；114例接受选择性淋巴引流区预 防照射46～52 Gy，原发肿瘤局部处方剂量56～70 Gy。采用Kaplan—Meier法计算局部控制率和os并 Logrank法检验和单因素预后分析。结果l、3、5年样本数分别为219、172、67例。累及野组与预防 野组1、3、5年局部控制率分别为63．0％、39．1％、27．2％和70．5％、53．3％、51．7％(P=0．013)，OS分 别为67．6％、24．9％、15．0％和73．7％、45．1％、26．0％(P=0．025)。单因素分层分析显示病变部位 为中下段、N0期的局部控制率和OS预防野组明显高于累及野组(P=0．007、0．015和P=0．054、 0．013)。结论对于食管原发肿瘤位于胸中下段和无淋巴转移患者，预防性淋巴引流区照射后局部 控制和长期生存均能获益。 【关键词】食管肿瘤／三维放射疗法； 累及野照射；选择性淋巴照射；预后 ·127· ·胸部肿瘤 A preliminary study of three-dimensional conformal radiotherapy with different clinical target volumes for esophageal cancer Zhu Shuchai，Xu Jinrui，Liu Zhikun，Su Jingwei，“Juan． Department ofRadiation Oncology，Fourth Hospital ofHebei Medical University，Shijiazhuang 050011，China 【Abstract】 Objective To investigate the value of prophylactic irradiation to the lymphatic drainage area in radical three．dimensional conformal radiotherapy f 3DCRT)and to evaluate the efficacy and adverse effects of 3DCRT with different clinical target volumes．Methods A retrospective analysis was performed on the reeords of 219 esophageal cancer patients without distant metastasis who received 3DCRT from January 2005 to December 2010．0Be hundred and five patients received involved—field irradiation(IFI)with a total dose of 54—6 Gy：1 14 patients reeeived elective nodal irradiation(ENI)with a total dose of 46—52 Gy： the prescribed dose to the primary lesion Was 56—_70 Gy．The Kapla凡一Meier method was used to calculate local control(LC)and overall survival(os)rates。and the log—rank test was used for univariate prognostic analysis．Results The 1-，3一。and 5-year sample sizes were 219，172 and 67，respectively．The 1-，3一， and 5-year LC rates for IFI group were 63．0％，39．1％，and 27．2％，respectively，versus 70．5％， 53．3％，and 51．7％for ENI group(X2=6．22，P=0．013)；the l一，3一，and 5-year OS rates for