CAJ | 학술논문

目的：分析食管癌术后辅助放疗对胸腔胃的照射剂量及胃镜下胃黏膜变化。方法：收集食管癌术后辅助放疗的患者45例，利用治疗计划系统制作放疗计划，并给予50Gy／25f 的处方剂量。根据术后胸腔胃位置不同，分为左侧、右侧及纵隔3组，每组15例。利用体积－剂量直方图分析比较各组胸腔胃接受的平均剂量（Dmean ）、接受5Gy、25Gy、40Gy、50Gy 照射的靶体积百分比（V5、V25、V40、V50）。观察患者放疗中上消化道不良反应情况，放疗后定期复查胃镜，观察胃黏膜变化。结果：纵隔胸腔胃受到照射的 Dmean、V5、V25、V40、V50明显高于左侧及右侧胸腔胃（P ＜0．05），左侧及右侧胸腔胃受照剂量无明显差异（P ＞0．05）。通过胃镜检查发现大部分患者出现黏膜充血水肿的表现，少部分患者有黏膜糜烂出血的表现。结论：纵隔胸腔胃较左侧及右侧胸腔胃受照剂量较大，放射性胃损伤发生几率可能高。
목적：분석식관암술후보조방료대흉강위적조사제량급위경하위점막변화。방법：수집식관암술후보조방료적환자45례，이용치료계화계통제작방료계화，병급여50Gy／25f 적처방제량。근거술후흉강위위치불동，분위좌측、우측급종격3조，매조15례。이용체적－제량직방도분석비교각조흉강위접수적평균제량（Dmean ）、접수5Gy、25Gy、40Gy、50Gy 조사적파체적백분비（V5、V25、V40、V50）。관찰환자방료중상소화도불량반응정황，방료후정기복사위경，관찰위점막변화。결과：종격흉강위수도조사적 Dmean、V5、V25、V40、V50명현고우좌측급우측흉강위（P ＜0．05），좌측급우측흉강위수조제량무명현차이（P ＞0．05）。통과위경검사발현대부분환자출현점막충혈수종적표현，소부분환자유점막미란출혈적표현。결론：종격흉강위교좌측급우측흉강위수조제량교대，방사성위손상발생궤솔가능고。
Objective:To investigate the dose and gastroscopic findings of thoracic stomach after adjuvant radio-therapy of resection of esophageal carcinoma.Methods:All 45 cases of esophageal cancer patients with postoperative radiotherapy were divided into 3 groups,the left,right and mediastinalintrathoracic stomach groups,each 15 cases.To use the radiotherapy planning system(TPS)to make radiotherapy plan,anduse the dose volume histograms diagram (DVH)to compare the average dose(Dmean ),the volume of stomach receiving 5Gy(V5 ),25Gy(V25 ),40Gy(V40 ), 50Gy(V50 )of theintrathoracic stomach.Digestive tract reaction were observed during radiotherapy,and the changes of gastric mucosa were observed by gastroscopy after radiotherapy.Results:The Dmean ,V5 ,V25 ,V40 ,V50 of mediastinal in-trathoracic gastric were significantly higher than that of left and right(P <0.05).Through the gastroscope inspection, we found that most thoracic stomach of patientsappearmucosal hyperemia and edema,few had mucosal erosion.Con-clusion:The dose of mediastinal intrathoracic stomach was larger than the left and right.The radioactive gastric injury occurrence probability may be high.