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颈段胸上段食管癌三维适形放射治疗疗效观察 被引量:48

3-dimensional conformal radiotherapy for cervical and upper-thoracic esophageal cancer
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摘要 目的 探讨三维适形放射治疗颈段胸上段食管癌的疗效和分析影响预后的因素。方法 回顾性分析 33例颈段胸上段食管癌患者接受三维适形放射治疗 ( 2Gy/次 ,5次 /周 ,总剂量 6 6~6 8Gy ,6~ 7周完成 )的疗效 ,生存分析采用Kaplan Meier法 ,多因素分析采用Cox比例风险模型。结果  1、2、3年局部控制率分别为 87.9%、75 .8%、4 5 .5 % ;1、2、3年生存率分别为 78.8%、6 6 .8%、4 4 .2 % ,中位生存期 33个月 ;1、2、3年无瘤生存率分布为 72 .7%、6 0 .6 %、30 .3%。急性放射反应主要是急性放射性食管炎和急性放射性气管炎 ,多为 1、2级。多因素分析结果显示原发肿瘤浸润深度、淋巴结转移和病变长度是影响预后的主要因素。结论 三维适形放射治疗是治疗颈段胸上段食管癌的有效治疗方法。原发肿瘤浸润深度、淋巴结转移和病变长度对患者的预后有重要影响。 Objective To evaluate the effect of 3-dimensional conformal radiotherapy (3D CRT) and prognostic factors for cervical and upper-thoracic esophageal cancer. Methods Between July 1998 and July 2001, 33 patients with cervical and upper-thoracic esophageal cancer were treated with 3D CRT(2?Gy per day, 5 sessions a week to a total dose of 66-68?Gy over 6-7 weeks). Acute toxicities and survival rates were evaluated by Kaplan-Meier method and prognostic factors were analyzed by Cox proportional hazard model. Results The 1-, 2-, 3-year local control rates were 87.9%, 75.8%, 45.5% respectively. The 1-, 2-, 3-year disease-free and overall survival rates were 72.7%, 60.6%, 30.3% and 78.8%, 66.8%, 44.2% respectively. GradeⅠ-Ⅱ acute esophagitis and bronchitis were the most common radiation side effects. Multivariate analysis revealed that the depth of primary tumor invasion, regional lymph node metastasis and tumor length were independent prognostic factors (P<0.05). Conclusions 3D CRT can be considered as an effective and feasible approach to cervical and upper-thoracic esophageal cancer treatment. The depth of primary tumor invasion, regional lymph node status and tumor length are important prognostic indicators for cervical and upper-thoracic esophageal cancer.
出处 《中华放射肿瘤学杂志》 CSCD 北大核心 2004年第4期270-272,共3页 Chinese Journal of Radiation Oncology
关键词 食管癌 三维适形放射治疗 疗效观察 预后 Esophageal neoplasms/radiotherapy Radiotherapy, conformal Prognosis
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