CAJ | 학술논문

目的：观察和探讨食管癌采用调强放疗肿瘤退缩的规律及临床应用价值。方法分析我院收治的38例食管癌患者，采用调强放疗进行治疗，收集在治疗过程中的所有肿瘤影像学资料，比较外照射前、照射至中位剂量达32 Gy 时、放疗结束时和放疗后6个月内患者实体肿瘤体积( gross tumor volume，GtV)变化情况，以及食管癌患者在治疗前半程、治疗后半程和治疗全程体积退缩率( volume reduction rate，Vrr)。结果患者在接受外照射前 GtV 范围为(5.49~110.39) ml，平均值为(32.78±5.33) ml，在照射至中位剂量32 Gy 时 GtV 范围为(4.89~80.15) ml，平均值为(23.56±3.40) ml，在治疗结束后 GtV 范围为(4.47~78.88) ml，平均值为(21.57±3.06) ml，治疗后6个月 GtV 范围为(5.06~32.96) ml，平均值为(15.8±2.28) ml 患者放疗前半程 Vrr 范围为-0.040~0.622，平均值为(0.193±0.032)，放疗后半程 Vrr范围为-0.414~0.311，平均值为(0.050±0.030)，放疗全程 Vrr 范围为-0.267--0.695，平均值为(0.225±0.046)；在接受放疗前半程患者 Vrr 明显高于后半程，差异具有统计学意义( P ＜0.05)。结论食管癌患者在接受放疗中瘤体体积不断退缩，退缩主要是在放疗前半程，医务工作者应根据影像学检查结果及时调整放疗靶区和放射剂量，在保证靶区高计量放射的同时，减少对周围组织的损伤。
목적：관찰화탐토식관암채용조강방료종류퇴축적규률급림상응용개치。방법분석아원수치적38례식관암환자，채용조강방료진행치료，수집재치료과정중적소유종류영상학자료，비교외조사전、조사지중위제량체32 Gy 시、방료결속시화방료후6개월내환자실체종류체적( gross tumor volume，GtV)변화정황，이급식관암환자재치료전반정、치료후반정화치료전정체적퇴축솔( volume reduction rate，Vrr)。결과환자재접수외조사전 GtV 범위위(5.49~110.39) ml，평균치위(32.78±5.33) ml，재조사지중위제량32 Gy 시 GtV 범위위(4.89~80.15) ml，평균치위(23.56±3.40) ml，재치료결속후 GtV 범위위(4.47~78.88) ml，평균치위(21.57±3.06) ml，치료후6개월 GtV 범위위(5.06~32.96) ml，평균치위(15.8±2.28) ml 환자방료전반정 Vrr 범위위-0.040~0.622，평균치위(0.193±0.032)，방료후반정 Vrr범위위-0.414~0.311，평균치위(0.050±0.030)，방료전정 Vrr 범위위-0.267--0.695，평균치위(0.225±0.046)；재접수방료전반정환자 Vrr 명현고우후반정，차이구유통계학의의( P ＜0.05)。결론식관암환자재접수방료중류체체적불단퇴축，퇴축주요시재방료전반정，의무공작자응근거영상학검사결과급시조정방료파구화방사제량，재보증파구고계량방사적동시，감소대주위조직적손상。
Objective: to observe and investigate esophageal intensity modulated radiation therapy (imrt) using rule and clinical value of tumor regression. Method analysis of our hospital of 38 patients with esophageal cancer, using intensity-modulated radiotherapy treatment, in the treatment of all tumor imaging in the process of information collection, comparison of external exposure, exposure to the median dose of 32 Gy before when, at the end of radiotherapy and radiotherapy in patients with solid tumors within six months after the volume (gross tumor volume, GtV), and esophageal cancer patients in the treatment of first half, second half and the entire treatment volume shrinking rate (volume reduction rate, VRR). Results patients before undergoing external exposure GtV range for ml (5.49-110.39), average (32.78-5.33) for ml, when exposure to the median dose of 32 Gy GtV scope for ml (4.89-80.15), average of ml (23.56 + 3.40), at the end of the treatment of GtV range for ml (4.47-78.88), average (21.57-3.06) for ml, 6 months after treatment of GtV range for ml (5.06-32.96), average of ml (15.8 +2.28) patients before radiotherapy half Vrr range to 0.040-0.622, average (0.193 + 0.032), second half radiotherapy Vrr range to 0.414-0.311, average (0.050 + 0.030), radiotherapy Vrr range to 0.267-0.267 - all the way, the average (0.225 + 0.046); in the first half radiotherapy patients VRR significantly higher than the second half, statistically significant difference (P < 0.05). Conclusion esophageal cancer patients undergoing radiotherapy in tumors had constantly shrinking volume, retreat is mainly in the first half, radiation medical workers should be according to the Results of imaging examination in a timely manner to adjust target and the radiation dose radiotherapy, the guarantee at the same time, the high dose radiation of the target to reduce damage to the surrounding tissues.