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目的探讨调强放射治疗(intensity-modulated radiotherapy,IMRT)对复发食管癌的近期疗效和急性放射不良反应。方法 50例首程放疗后复发的食管癌患者,行IMRT治疗,放疗处方剂量中位值54Gy(50～60Gy),1.8～2.0Gy/次,5次/周。结果本组患者首程放疗至再程放疗时间11～30个月,均完成IMRT治疗,完全缓解7例、部分缓解28例、无变化11例、进展4例,治疗有效率70%;IMRT治疗中发生急性放射性食管炎1～2级8例、3级3例,急性放射性肺炎1～2级17例,骨髓抑制1～2级16例,急性心脏损伤1～2级3例,其发生率分别为22.0%,34.0%,32.0%,6.0%,但均未发生4级放射性不良反应。结论 IMRT治疗放疗后复发性食管癌近期疗效满意,急性放射不良反应发生率较低。
Objective To investigate the short-term efficacy and acute radiation-induced adverse reactions of intensity-modulated radiotherapy (IMRT) on recurrent esophageal cancer. Methods Fifty patients with esophageal cancer who relapsed after the first course of radiotherapy were treated with IMRT. The median dose of radiotherapy was 54 Gy (50-60 Gy), 1.8-2.0 Gy / time and 5 times / week. Results In the first course of radiotherapy, the duration of first-course radiotherapy was 11 to 30 months. IMRT was completed in 7 cases, complete remission in 7 cases, partial remission in 28 cases, no change in 11 cases, progression in 4 cases, and the effective rate was 70%. IMRT treatment In 8 cases of acute esophagitis grade 1, 3 in 3 cases, 17 cases of acute radiation pneumonitis grade 1 to 2, bone marrow suppression in 1 to 2 grade 16 cases, acute heart injury in 1 to 2 3 cases, the incidence Respectively, 22.0%, 34.0%, 32.0%, 6.0%, but no grade 4 radioactive adverse reactions. Conclusion IMRT treatment of recurrent esophageal cancer after radiotherapy recent satisfactory results, the incidence of acute radiation adverse reaction is low.