食管癌束流调强放射治疗的临床疗效观察

The Clinical Observation of Intensity-modulated Radiotherapy for Esophageal Carcinoma

目的探讨束流调强放射治疗（IMRT）食管癌的疗效及其不良反应。方法采用IMRT方法，治疗食管癌45例单次分割剂量2．0～2．5Cy／次，1次／天，5次／周，共25～33次，总剂量50～66Gy，中位处方剂量60Gy。结果总有效率（CR＋PR）为91．1％。1、2、3年局部控制率分别为91．1％、77．8％和62．2％，1、2、3年生存率分别为88．9％、68．9％、51．1％。中位生存期36．4个月。仅1例出现3级食管炎，余放射不良反应均为0～2级。结论IMRT能明显提高食管癌患者的局部控制率和生存率，同时能更好地保护正常组织。

Objective To evaluate the effect and adverse reactions of IMRT for esophageal carcinoma. Methods 45 patients with esophageal carcinoma received IMRT with total prescription dose rang from 50 Gy to 66 Gy/25 in 33 fractions. The median prescribed dose was 60Gy,2.0Gy to 2.5 Gy/fraction,5 fractions/week. Results The overall response rate was 91.1%, and the 1,2 and 3 year local control rates were 91.1% ,77.8% and 62.2% ,respectively. The 1,2 and 3 year over-all survival rates were 88.9% ,68.9% and 51.1% , respectively. The median survival time for these patients was 36.4months. The toxicities were minimum except one patient with grade Ⅲ esophagitis. Conclusion IMRT could improve the local control and the overall survival rate of esophageal carcinoma with minimum toxicities.