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目的探讨常规放疗、三维适形放疗(3DCRT)、调强放疗(IMRT)治疗食管癌的疗效差异。方法 117例食管癌中,38例采用常规放疗,32例采用3DCRT,47例采用IMRT。并对疗效和毒副反应进行比较分析。结果常规放疗组、3DCRT组和IMRT组的有效率分别为92.1%、96.9%、91.5%,差异无统计学意义(P=0.617)。3组1年生存率分别为77.9%、87.5%、86.7%(P=0.193);2年生存率分别为38.6%、55.1%、57.7%(P=0.211)。3DCRT组+IMRT组总疼痛缓解率为90.9%,常规放疗组为84.6%,差异无统计学意义(P=0.642)。放射性食管炎发生率3DCRT组+IMRT组较常规放疗组高(P=0.012),放射性肺炎发生率常规放疗组较3DCRT组+IMRT组高(P<0.001),放射性气管炎常规放疗组较3DCRT组+IMRT组高(P=0.028),骨髓抑制常规放疗组较3DCRT组+IMRT组高(P=0.010)。结论 3DCRT和IMRT能提高食管癌的临床疗效,并减轻患者的放射性损伤。
Objective To investigate the curative effect of conventional radiotherapy, three-dimensional conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) on esophageal cancer. Methods 117 cases of esophageal cancer, 38 cases of conventional radiotherapy, 32 cases with 3DCRT, 47 cases with IMRT. And the efficacy and toxicity were compared. Results The effective rates of conventional radiotherapy, 3DCRT and IMRT were 92.1%, 96.9% and 91.5% respectively, with no significant difference (P = 0.617). The 1-year survival rates of three groups were 77.9%, 87.5% and 86.7%, respectively (P = 0.193). The 2-year survival rates were 38.6%, 55.1% and 57.7%, respectively. The overall pain relief rate was 90.9% in the 3DCRT + IMRT group and 84.6% in the conventional radiotherapy group, with no significant difference (P = 0.642). The incidence of radiation esophagitis was higher in the 3DCRT + IMRT group than in the conventional radiotherapy group (P = 0.012). The incidence of radiation pneumonitis was higher in the conventional radiotherapy group than in the 3DCRT + IMRT group (P <0.001) + IMRT group (P = 0.028), the conventional radiotherapy group with myelosuppression was higher than the 3DCRT group + IMRT group (P = 0.010). Conclusion 3DCRT and IMRT can improve the clinical curative effect of esophageal cancer and reduce the radiation injury of patients.