三维适形放射治疗常规外照射后复发的食管癌

3-D conformal radiation therapy for postradiation recurrent esophageal carcinoma

目的 :研究三维适形放射治疗常规放射治疗后复发的食管癌可行性。方法 :2 0例食管癌放射治疗后复发病例 ,实施适形放射治疗 ,照射剂量为 4 5～ 6 0Gy,3 0Gy/次 ,1次 /d ,5d/周。结果 :急性放射性食管炎发生率 1～ 2级 6 5 % (13/2 0 )、3级 35 % (7/ 2 0 ) ;急性放射性气管炎发生率 1～ 2级 35 % (7/ 2 0 )、3级 5 % (1/ 2 0 ) ;骨髓抑制发生率 1～ 2级 5 0 % (10 / 2 0 )、3级0 % (0 / 2 0 ) ;总有效率为 10 0 % ,其中完全缓解 (CR) 80 % (16 / 2 0 ) ,部分缓解 (PR) 2 0 % (4/ 2 0 )。 1、2年生存率分别为 6 9 2 % (9/13)、4 2 9% (3/ 7)。结论 :三维适形放射治疗常规外照射后复发的食管癌有较好的近期疗效 ,早期并发症较低 ,能为患者耐受 ,晚期并发症的发生率及远期疗效有待进一步观察。

Objective:To evaluate the feasibility of radiation for postradiation recurrent esophageal carcinoma using 3-dimensional conformal radiotherapy (3-D CRT).Methods:Twenty esophageal carcinoma patients with local recurrence after their initial radiotherapy accepted with 3-D CRT. The total irradition dose, ranging from 45Gy to 60Gy, was delivered to 3.0Gy once daily, 5 days per week.Results:Grade 1～2 acute radiation esophagitis occurred in 65%(13/20) and grade 3 in 35% (7/20) patients; Grade 1～2 acute radiation bronchitis occurred in 35% (7/20) and grade 3 in 5%(1/20) patients;Grade 1～2 bone marrow suppression occurred in 50% (10/20) patients.The overall response rate was 100%, with complete response (CR) 80% (16/20) and partial response (PR) 20% (4/20), The 1-and 2-year survival rates were 69.2% (9/13),42.9%(3/7).Conclusion:3-D CRT can be considered effective postradiation local recurrence of esophageal carcinoma. With fewer acute complications.Complications and long-term survival require further study.