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目的探讨食管癌适形放疗的临床疗效,分析患者的急性放射性损伤情况,为适形放疗的临床应用提供参考。方法选择2006年1月-2009年12月我院收治的30例食管癌患者进行三维适形放疗,随机挑选30例食管癌患者作为对照组进行常规放疗。对两组患者1-3年生存率及急性放射性损伤情况进行随访观察和分析。结果两组患者1年生存率、2年生存率差异均无统计学意义(P>0.05)。适形放疗组患者的3年生存率显著高于对照组(P<0.05)。两组患者均顺利完成整个化疗进程。适形放疗组患者有2例发生Ⅰ级食管放射损伤,1例发生Ⅱ级食管放射损伤,1例发生Ⅲ级食管放射损伤,1例发生肺部放射损伤,未有患者发生放射性肺炎,有4例患者发生放射性气管炎,适形放疗组患者的急性放射性损伤发生率较低,但两组患者的急性放射性损伤发生率差异无统计学意义。结论三维适形放疗可提高食管癌患者的生存率,并减少放疗的损伤,更有利于患者的接受。
Objective To investigate the clinical efficacy of conformal radiotherapy for esophageal cancer and to analyze the acute radioactive injury in patients and provide reference for the clinical application of conformal radiotherapy. Methods Thirty cases of esophageal cancer treated in our hospital from January 2006 to December 2009 were treated with three-dimensional conformal radiotherapy. Thirty patients with esophageal cancer were randomly selected as the control group for conventional radiotherapy. The 1- and 3-year survival rates and acute radiation injury of the two groups were followed up and analyzed. Results There was no significant difference in 1-year survival rate and 2-year survival rate between the two groups (P> 0.05). The 3-year survival rate of conformal radiotherapy group was significantly higher than that of control group (P <0.05). Two groups of patients successfully completed the entire course of chemotherapy. In the conformal radiotherapy group, there were 2 cases of grade Ⅰ esophageal radiation injury, 1 case of grade Ⅱ esophageal radiation injury, 1 case of grade Ⅲ esophageal radiation injury, 1 case of lung radiation injury, and no case of radiation pneumonitis. Radiation tracheitis occurred in the patients. The incidence of acute radiation injury in conformal radiotherapy group was lower, but there was no significant difference between the two groups in the incidence of acute radiation injury. Conclusion Three-dimensional conformal radiotherapy can improve the survival rate of patients with esophageal cancer and reduce radiation injury, more conducive to the patient’s acceptance.