不同剂量放射治疗80岁以上食管癌的临床观察.docxVIP

不同剂量放射治疗80岁以上食管癌的临床观察 徐宜全，赵坤（通讯作者），郭全全 江苏省沐阳县人民医院肿瘤科，江苏沐阳223600 【摘要】目的探讨不同照射剂量在三维适形放疗治疗80岁以上老年食管 癌中的疗效及毒副作用。方法 我院经病理确诊的58例老年食管癌患者，随机分 为2组，均采用三维适形放疗技术，所有入组患者均未接受化疗及手术治疗。26 例（A组）放疗总剂量46?52Gy /23?26次，32例（B组）放疗总剂量54? 60Gy/27?30次。结果 放疗结束1月时两组总有效率分别为61.5%和90.6%,有 显著差异（P0.05）;B组患者发牛山?IV级放射性气管炎和放射性肺炎者增多， 放射性食管炎和骨髓抑制发生率两组相似，1、3年局控率分别为80.7%、26.9% 和 87.5%、59.3% ;1、3 年生存率分别为 88.4%、30.7%和 96.8%、62.5% ;两组 1 年 局控率及牛存率无显著差异，但3年局控率及牛存率有显箸差异，Plt;0.05o结论 三维适形放疗治疗80岁以上老年食管癌患者剂量54?60Gy安全、有效，可提 高老年食管癌远期疗效。 【关键词】食管癌；放射治疗；剂量分割 Clinical study on effect of radiatherapy with different doses in Esophageal Cancer in Patients over 80 Years Old XU Yi-quan , ZHAO Kun Department of Oncology, The Peoplersquo;s Hospital of Shuya ng, Jia ngsu, 223600,China; 【Abstract 】Objective To investigate the curative effect and side effect with different dose radiation in esophageal cancer in patients over 80 years old. Methods A total of 58 patients with histologically conformed esophageal Cancer in our hospital were give n radiotherapy with different dose radiati on scheme of 3DCRT. Patients were divided into 2 groups,26 patients（group A） received radiotherapy with 46?52Gy/23?26 fractions, another 32 patients(group B) received radiotherapy with 54?60Gy/27?30 fractions.AII enrolled patients were not treated with chemotherapy and surgicaltherapy.Results One month later after radiotherapy,short-term response was 61.5%,90.6% respectively the differenee was statistically significant ( P0.05)? The incidence of radiation bronchitis,pulmonitis(grade III, grade IV), in group B was higher than group A.The incidenee of Esophagitis, myelosuppression from both groups were similar.Local control rate and survival rate from group B at the 3rd years were significantly higher than those from group A(26.9%vs59.3%,30.7%vs62.5%).At the 1st both groups in were similar(80.7%vs87.5%,88.4%vs96.8%).Conclusion The 3DCRT with 54?60Gy can safely and effectively treat the esophageal cancer patients over 80 Years Old,the long-term curative