论文部分内容阅读
目的:应用三维适形放射治疗技术进行不同分割剂量治疗食管癌的近期疗效。方法:52例中段食管癌均为首治病例,分为常规分割剂量组(CFRT组)21例、大分割剂量组(LFRT组)17例及后程加速超分割剂量组(AHRT组)14例,前两组全程采用三维适形放射治疗技术进行治疗,后一组先行常规放疗后再行适形放疗,处方剂量为65-70Gy,照射剂量参考线为90%等剂量曲线。观察患者的近期疗效及副反应发生率。结果:治疗后不同阶段复查CT及食管钡透。三组进食改善率和近期有效率均为100%,且均未出现放射性肺炎,急性放射性食管炎在CFRT组为57.1%(12/21),LFRT组为82.4%(14/17),AHRT组为71.4%(10/14),晚期食管并发症发生率在CFRT组为23.8%(5/21),LFRT组为70.6%(12/17),AHRT组为21.4%(3/14),主要包括食管狭窄和溃疡,出现时间为放射治疗开始后4-14月。结论:三维适形放射治疗食管癌可降低正常组织副作用,后程加速超分割和常规分割剂量适形放疗是食管癌的主要放疗方式,大分割剂量放疗不适于食管癌的放射治疗,可以增加晚期并发症,影响患者的生存质量甚至生存期。
Objective: To apply three-dimensional conformal radiotherapy technology to treat different doses of esophageal cancer in the short term. Methods: Fifty-two patients with middle esophageal cancer were included in this study. Twenty-one patients were divided into two groups: conventional fractionation (CFRT) group (21 cases), large fractionation group (LFRT group), and late accelerated accelerated fractionation group (AHRT group) The first two groups were treated with three-dimensional conformal radiotherapy, while the latter group received conformal radiotherapy after conventional radiotherapy. The prescription dose was 65-70 Gy and the dose of radiation dose reference curve was 90%. Observed the patient’s immediate effect and the incidence of side effects. Results: CT and esophageal barium were examined at different stages after treatment. The improvement rates of the three groups were all 100%, and no radiation pneumonitis was found in the three groups. The incidence of acute radiation esophagitis was 57.1% (12/21) in CFRT group, 82.4% (14/17) in LFRT group, (71.4%, 10/14). The incidence of advanced esophageal complications was 23.8% (5/21) in the CFRT group, 70.6% (12/17) in the LFRT group and 21.4% (3/14) in the AHRT group Including esophageal stenosis and ulcers, the appearance of radiation therapy after the start of 4-14 months. Conclusions: Three-dimensional conformal radiotherapy of esophageal cancer can reduce the side effects of normal tissue, the late accelerated hyperfractionation and conventional fractionated dose conformal radiotherapy is the main radiation treatment of esophageal cancer, the large fractionated radiotherapy is not suitable for esophageal cancer radiotherapy, can increase late Complications affect the quality of life of patients and even survival.