中、晚期中段食管癌应用后程及全程三维适形放疗比较.docVIP

中、晚期中段食管癌应用后程及全程三维适形放疗比较 　作者：鄂有国，曹德华，朱倩，钱月红，赵枫 【摘要】 目的： 寻找一种适合中、晚期中段食管癌的疗效高，并发症少，复发率低，经济且简便的放疗方法。方法： 将60例中、晚期中段食管癌患者随机分为两组进行治疗。一组采用全程三维适形放疗；另一组前半程常规放疗后半程采用三维适形放疗。对两种治疗方法的局部控制率、生存率等一系列相关指标进行随访、对比分析。结果： 除两侧锁骨上淋巴结转移率后程三维适形放疗组明显低于全程三维适形放疗组，差异有统计学意义外，两种方法的1～3年的病灶局部控制率、生存率以及放射性食管炎、放射性肺炎的发生率等差异均无统计学意义。结论： 对于中、晚期中段食管癌的放疗而言，前程包及两侧锁骨上区的常规放疗加后程三维适形放疗的应用在一定程度上优于全程三维适形放疗，尤其适合于广大农村地区。 【关键词】 食管癌；中段； 三维适形； 放疗 　　［Abstract］Objective: To find the programme which may be high effect but little side reaction, with lower local failure rate, and is economical and concise in treating the patient suffered from progressive esophageal carcinoma in the middle part of esophagus. Methods： Sixty patients who suffered from progressive esophageal carcinoma in the middle part of esophagus were divided randomly into two groups:(1)whole course threedimensional conformal radiotherapy;(2)the lately half course of threedimensional conformal radiotherapy after previous half course conventional radiotherapy. The local control rate and survival rate and some other signs of two group patients were followed up and to be compared and analysed. Results： There was no significant difference in two treat programmes about the local control rate and survival rate of 1,2,3year and rate of radiationinduced pneumonitis and radiationinduced esophagitis. However, there was higher metastatic rate of lymphnodes above two side clavicle in the whole course threedimensional conformal radiotherapy group than in the lately half course threedimensional conformal radiotherapy group. Conclusion： The programme of the lately half course of threedimensional conformal radiotherapy after previous half course of conventional radiation of including the area above two side clavicles in treating progresive esophageal carcinoma in the middle part of esophagus was better in certain degree than whole course of threedimensional conformal radiotherapy and suitable particularly for the patients in countryside area. 　　［Key