中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2013年
20期
1248-1251
,共4页
李多杰%李红伟%何斌%汪庚明%蔡汉飞%段诗苗%沈学明%江浩%彭开桂
李多傑%李紅偉%何斌%汪庚明%蔡漢飛%段詩苗%瀋學明%江浩%彭開桂
리다걸%리홍위%하빈%왕경명%채한비%단시묘%침학명%강호%팽개계
食管肿瘤%适形调强放射疗法%临床靶体积%预后
食管腫瘤%適形調彊放射療法%臨床靶體積%預後
식관종류%괄형조강방사요법%림상파체적%예후
esophageal neoplasms%definitive radiotherapy%clinical target volume%prognosis
目的：回顾性分析食管癌不同临床靶体积对适形调强放射治疗疗效及失败模式的影响，探讨不进行淋巴结预防照射是否可行。方法：2007年1月至2011年6月本院收治行根治性三维适形放疗（3 dimensional conformal radiotherapy，3D-CRT）/调强放疗（intensity modulated radiation therapy，IMRT）的食管鳞状细胞癌患者共68例，根据CTV范围不同分成淋巴结累及野组（累及野组）和淋巴结扩大野组（扩大野组）。结果：累及野组和扩大野组1、2年的生存率分别为59%、41%和61%、39%（P=0.56），局部控制率分别为66%、48%和68%、49%（P=0.78）。累及野组和扩大野组总失败率分别为63%和66%（P=0.89），局部失败率为53%和59%，远处转移失败率分别为47%和44%，区域失败率分别为11.8%和7.5%，两者比较差异无统计学意义（P=0.39）。扩大野组肺V10、V20、V30及肺平均受量等指标均大于累及野组，其中V10和肺平均剂量比较差异有统计学意义。结论：累及野组在生存率、局部控制率方面和扩大野组相似，野内复发和远处转移是治疗失败的主要原因，局部晚期食管癌患者行累及野放疗是安全的。
目的：迴顧性分析食管癌不同臨床靶體積對適形調彊放射治療療效及失敗模式的影響，探討不進行淋巴結預防照射是否可行。方法：2007年1月至2011年6月本院收治行根治性三維適形放療（3 dimensional conformal radiotherapy，3D-CRT）/調彊放療（intensity modulated radiation therapy，IMRT）的食管鱗狀細胞癌患者共68例，根據CTV範圍不同分成淋巴結纍及野組（纍及野組）和淋巴結擴大野組（擴大野組）。結果：纍及野組和擴大野組1、2年的生存率分彆為59%、41%和61%、39%（P=0.56），跼部控製率分彆為66%、48%和68%、49%（P=0.78）。纍及野組和擴大野組總失敗率分彆為63%和66%（P=0.89），跼部失敗率為53%和59%，遠處轉移失敗率分彆為47%和44%，區域失敗率分彆為11.8%和7.5%，兩者比較差異無統計學意義（P=0.39）。擴大野組肺V10、V20、V30及肺平均受量等指標均大于纍及野組，其中V10和肺平均劑量比較差異有統計學意義。結論：纍及野組在生存率、跼部控製率方麵和擴大野組相似，野內複髮和遠處轉移是治療失敗的主要原因，跼部晚期食管癌患者行纍及野放療是安全的。
목적：회고성분석식관암불동림상파체적대괄형조강방사치료료효급실패모식적영향，탐토불진행림파결예방조사시부가행。방법：2007년1월지2011년6월본원수치행근치성삼유괄형방료（3 dimensional conformal radiotherapy，3D-CRT）/조강방료（intensity modulated radiation therapy，IMRT）적식관린상세포암환자공68례，근거CTV범위불동분성림파결루급야조（루급야조）화림파결확대야조（확대야조）。결과：루급야조화확대야조1、2년적생존솔분별위59%、41%화61%、39%（P=0.56），국부공제솔분별위66%、48%화68%、49%（P=0.78）。루급야조화확대야조총실패솔분별위63%화66%（P=0.89），국부실패솔위53%화59%，원처전이실패솔분별위47%화44%，구역실패솔분별위11.8%화7.5%，량자비교차이무통계학의의（P=0.39）。확대야조폐V10、V20、V30급폐평균수량등지표균대우루급야조，기중V10화폐평균제량비교차이유통계학의의。결론：루급야조재생존솔、국부공제솔방면화확대야조상사，야내복발화원처전이시치료실패적주요원인，국부만기식관암환자행루급야방료시안전적。
Objective:To retrospectively analyze the treatment effect and the patterns of failure associated with different clinical target volume on patients with esophageal cancer treated with three dimensional conformal or intensity modulated radiotherapy, and to determine whether involved field radiotherapy is practicable in these patients. Methods:A total of 68 patients with esophageal squa-mous cell carcinoma between January 2007 to June 2011 in our hospital underwent three dimensional conformal or intensity modulated radiotherapy, according to the CTV range is divided into lymph involved-field group (involved field group) and lymph extended field group (extended field group). Results:In Involved field group and expand field group the survival rate of 1, 2 years were 59%, 41%and 61%, 39% respectively (P=0.56), and local control rates were 66%, 48% and 68%, 49% respectively(P=0.78). The total failure rates of involved field and the expand field were 63%and 66%(P=0.89). The local failure rate was 53%and 59%, distant metastasis failure rates were 47%and 44%, the regional failure rates were 11.8%and 7.5%in Involved field and the expand field, there were no difference in Statistics (P=0.39). The lung V10, V20, V30 and mean lung dose of extended field group were greater than that of the in-volved field group, while the mean lung dose and V10 has statistical difference. Conclusion:The involved field group was similar as the extended field group in the survival rate and local control rate, the regional recurrence and distant metastasis are the main cause of treatment failure, so the involved field radiotherapy is feasible for locally advanced esophageal carcinoma.
