食管癌三维适形放射治疗的随访结果

Follow-up Results of Three Dimensional Conformal Radiotherapy for Esophageal Cancer

[目的]探讨三维适形放射治疗(3D-CRT)食管癌的生存情况及局部控制情况。[方法]回顾性分析2000年10月至2004年12月期间182例食管癌病人接受3D-CRT的随访结果。治疗方法:采用三野以上多野共面照射为主,少数病例用非共面照射;剂量50～70Gy/5～7周,2Gy/次,每周5次(有8例采用后程加速超分割方案)。[结果]全组中位生存时间21个月;1、2、3、5年总生存率分别为71.2%、47.5%、36.6%、29.5%;1、2、3、5年无病生存率分别为55.9%、38%、31.8%、26.6%;1、2、3、5年局部控制率70.3%、62.8%、56.1%、54.5%;食管肿瘤未控或复发仍是死亡的第一原因,占死因的46.6%。[结论]三维适形放射治疗食管癌可取得较好的生存率和局部控制率。

[Purpose] To investigate the effects of three-dimensional conformal radiotherapy （3D-CRT） on the survival and local control outcome in the patients with esophageal cancer. [Methods] From October 2000 to December 2004, 182 patients with esophageal cancer received coplanarity or noncoplanarity multifield 3D-CRT. The dose delivered was 2Gy per fraction, 5 fractions per week, with a total dose of 50-70Gy in 5-7 weeks （except for 8 cases with late course accelerated hyperfractionation schema）. [Results] The median survival of the cohort was 21 months. One-year, 2-year, 3-year and 5-year overall survival rates were 71.2%, 47.5%, 36.6% and 29.5%, respectively. One-year, 2- year, 3-year and 5-year disease free survival rates were 55.9%, 38%, 31.8% and 26.6%, respectively. 1-year, 2-year, 3-year and 5-year local tumor control rates were 70.3%, 62.8%, 56.1% and 54.5%, respectively. Failure of local control or recurrence of esophageal cancer （46.6%） remained the primary cause of death. [Conclusions] By using of 3D-CRT technique, the local tumor control rate and survival rate for the patients with esophageal cancer are improved.