食管癌术后纵隔转移灶后程加速超分割三维适形放射治疗.pdfVIP

第 25 卷第 11 期 南京医科大学学报(自然科学版) 2∞5 年 11 月 ACTA UNIVERSITAηSM且DICINAUS NANJING(Natural Science) .827. 食管癌术后纵隔转移灶后程加速超分割王维适形放射治疗 于长华，岳顺，李涛，徐益明，谢苏舟，周建农l (南京医科大学附属淮安医院肿瘤放疗科，iI苏谁安 223300; J 江苏省肿瘤医院，江苏南京 21∞08) [摘 要] 因的:探讨胸段食管癌根治术后纵隔转移灶后程加速超分割三维适形放射治疗的意义和效果。方法:104例食管癌 根治术后发生纵隔转移患者，随机分为常规治疗组和研究组。开始治疗时两组均采用前后两野同照放射治疗，分割剂量 DT2 .0 Gyl次，5次/周，照射38 Gy后常规组根据CT复圣经情况重新模拟机定位，两野或者主野避脊髓继续常规分割治疗。研究组 行CTsim定位，进行兰兰维滔形计划设计，新计划以DT1.5 印次，2次Id ， 张脯，常规组照射目标剂量60 句，研究组照射目标剂最68 Gyo 结果:治疗后3 个月复资CT，各组病灶达CRi等 14//29例，分别ð26.9%和55.8% ，各级病灶达PR者26/22例，分别占50.0%和 42.39奋，两组总的有效率(CR + PR)分别是76.99导和98.1%。结论:食管癌根治术后纵隔转移患者进行后穆加速趟分割._维适形 放射治疗可以明显提高局部控制惑，疗效达CR和CR + PR的患者均有统计学差异(P ~ 0.005和P 需:::; 0.05) ，急性放射治疗反应 可耐受，具有良好的应用前景。 [关键词] 食管肿瘤;纵隔转移;三维适形放射治疗;后程加速超分割 {申图分类号] R735. 1 [文献标识码] A [文章编号] 1 ∞7-4368(2∞5)11-0827幽03 Late-course accelerated hype同rationated 3-dimmentional conformal radiation therapy(3-D CRT) for mediastinum metastasis in patients with esophageal carcinoma after oper副ion l YU Chang-hua ,YUE Shun , 11 Tao ,XU Yi-ming , XIE Su-dan ,ZHOU Jian-nong (Department 01 Radiation Oncology ， Huαi an First People s Hospit a1, H川ian 223300;1 且伽，gsu Cancer Hospit a1 ， NaJ扩ing 210008 ,Chinα) [AbstractJ Objective: To study the effects of late唰course accelerated hyperfrationat制1 3-dimmentional conformal radiation therapy (LCAH 子DCRT) for mediastinum metastasis in patients with esophageal carcinoma after carcinoma. Me仙。ds :One hundred and four patients were randomly divided into 2 groups (conventional treatment group and study group ).All accepted conventional RT at first. When the do附 reached 38Gy ,the conventìonal treatment group changed the angle ωavoid the spinal cor吐， with the total dose of