三维适形放疗急性放射性食管炎影响因素的临床研究

Risk factors related to acute radiation esophagitis induced by 3-dimension conformal radiotherapy

目的探讨胸部恶性肿瘤三维适形放疗所引起的急性放射性食管炎的发生率和影响因素。方法60例非小细胞肺癌和食管癌患者进入本研究,单纯三维适形放疗39例,放疗、化疗同期治疗21例,化疗采用CMV或FP方案。患者临床特征和治疗参数指标包括:性别、年龄、是否同期化疗、射野内食管长度、整个食管的平均剂量、食管的最大剂量点剂量。针对RTOG分级≥2级的急性放射性食管炎患者分析上述指标。结果26例(43.3%)患者出现了≥2级的急性放射性食管炎,其中2级18例(69.2%);3级7例(26.9%);4级1例(3.9%)。发现同期放疗、化疗和整个食管的平均剂量对急性放射性食管炎的发生是有统计学意义的影响因素(P<0.05)。结论在三维适形放疗中,同期放疗、化疗和整个食管的平均剂量是急性放射性食管炎发生的影响因素。

Objective To investigate the risk factors related to acute esophagitis induced by 3-dimension conformal radiation therapy （3D-CRT） for cancers in the thorax. Methods Sixty patients with lung cancer and esophageal cancer were recruited in the study from October 2003 to January 2006. Thirty-nine patients were treated with 3D-CRT alone and 21 patients received concurrent chemotherapy （CMV or FP regimens）. The following parameters were analyzed against esophagitis of grade 2 or above on RTOG criteria： gender,age,current chemotherapy; length of esophagus in treatment field, mean dose to the entire esophagus and maximal point dose to esophagus. Results Acute radiation esophagitis occurred in 26 patients（43. 3%）with 18（69. 2%） in grade 2, 7（26. 9%） in grade 3,and 1（3. 9%） in grade 4,respectively. Concurrent chemotherapy and mean dose to the entire esophagus demonstrated a statistically significant correlation with the incidence of esophagitis. Conclusion Concurrent chemotherapy and mean dose to the entire esophagus are the risk factors related to radiation esophagitis in patients treated with 3D-CRT.