CAJ | 학술논문

背景与目的：调强放疗(intensity modulated radiation therapy，IMRT)是在最大限度提高肿瘤靶区照射剂量的同时明显减少周围正常组织剂量的放疗技术，化疗是防止远处转移的有效手段。本文旨在观察IMRT同步化疗治疗中晚期食管癌的临床效果。方法：将62例中晚期食管癌患者分为两组，其中同步放化疗组(IMRT+化疗)32例，单纯放疗组(单纯IMRT)30例。两组患者均采用IMRT放疗，同步放化疗组同期采用化疗方案TP(紫杉醇175 mg/m2，第1天；奈达铂，30 mg/m2，第1~3天)，化疗28 d为1个周期，至少化疗2个周期。比较两组近期临床疗效及不良反应。结论：同步放化疗组有效率(CR+PR)为93.8%，高于单纯放疗组的76.7%，差异有统计学意义(P<0.05)，同步放化疗组的1、2年局控率(84.4%、59.4%)高于单纯放疗组(70.0%、36.7%)，差异有统计学意义(P<0.05)；两组的生存率差异无统计学意义(P>0.05)；同步放化疗组白细胞下降和放射性食管炎发生率以及Ⅲ、Ⅳ级不良反应发生率均明显高于单纯放疗组(P<0.05)。
배경여목적：조강방료(intensity modulated radiation therapy，IMRT)시재최대한도제고종류파구조사제량적동시명현감소주위정상조직제량적방료기술，화료시방지원처전이적유효수단。본문지재관찰IMRT동보화료치료중만기식관암적림상효과。방법：장62례중만기식관암환자분위량조，기중동보방화료조(IMRT+화료)32례，단순방료조(단순IMRT)30례。량조환자균채용IMRT방료，동보방화료조동기채용화료방안TP(자삼순175 mg/m2，제1천；내체박，30 mg/m2，제1~3천)，화료28 d위1개주기，지소화료2개주기。비교량조근기림상료효급불량반응。결론：동보방화료조유효솔(CR+PR)위93.8%，고우단순방료조적76.7%，차이유통계학의의(P<0.05)，동보방화료조적1、2년국공솔(84.4%、59.4%)고우단순방료조(70.0%、36.7%)，차이유통계학의의(P<0.05)；량조적생존솔차이무통계학의의(P>0.05)；동보방화료조백세포하강화방사성식관염발생솔이급Ⅲ、Ⅳ급불량반응발생솔균명현고우단순방료조(P<0.05)。
Background and purpose:Intensity-modulated radiation therapy (IMRT) enables the delivery of higher radiation dose to the primary tumor target, while sparing the organs and tissues at risk (OARs). Chemotherapy is an effective means to prevent distant metastasis. The purpose of this study was to observe clinical effect of concurrent intensity-modulated radiation therapy and chemotherapy for advanced esophageal carcinoma. Methods: A total number of 62 cases of advanced esophageal carcinoma were divided into two groups. There were 32 cases in concurrent chemoradiotherapy group, and 30 cases were in radiotherapy alone group. The patients in two groups were both used IMRT radiotherapy, while the patients of concurrent chemoradiotherapy group were plused adjuvant chemotherapy. The chemotherapy regimen was TP. Twenty-eight days was a treatment cycle, 2 treatment cycles were lasted during chemoradiotherapy.After that, recent curative effect and toxicside reaction were compared between two groups. Results: The total relief rate (CR+PR) in concurrent chemoradiotherapy group was 93.8%. The total relief rate in radiotherapy alone group was 76.7%. There were signiifcant differences between the two groups (P<0.05). One-year local response rate(84.4%) and 2-year local response rate (59.4%) in concurrent chemoradiotherapy group were both higher than those (70.0%, 36.7%) in radiotherapy alone group (P<0.05), while the survival rate was similar between the two groups (P>0.05). Toxicside reaction in concurrent chemoradiotherapy group, including leucocytes decrease, radioactive esophagitis andⅢ,Ⅳtoxicity, were higher than those in radiotherapy alone group (P<0.05). Conclusion:After treating advanced esophageal carcinoma with concurrent intensity-modulated radiation therapy and chemotherapy, the recent curative effect and the local response were ifne, while toxicity was more serious.