51例老年食管癌三维适形放疗疗效分析

Treatment outcomes of three-dimensional conformal radiotherapy for 51 elderly patient with esophageal carcinoma

目的探讨老年食管癌患者三维适形放疗（three．dimensional conformal radiotherapy，3-DCRT）的临床疗效。方法51例老年食管癌患者采用三维适形放疗，2Gy／次，1次／天，5次／周，全组处方剂量52．60Gy，中位剂量56Gy。（设4-6个弧形或非共面适形固定野照射，参考剂量曲线选定为90％）。结果治疗后1-3个月内复查增强CT或食道钡餐造影，51例患者中，获CR4例（7．8％），PR40例（78．4％），SD6例（11．8％），无PD，总有效率RR（CR＋PR）为44例（86．2％）。全组1、2、3年生存率分别为53．3％、31．1％和19．5％，中位生存期16个月。全组无严重并发症发生。结论三维适形放射治疗老年食管癌能提高肿瘤局部照射剂量和增加肿瘤局部控制率，能改善生活质量，有望延长生存期，是一种安全、有效的治疗手段。

Objective To discuss the clinical results of three-dimensional conformal radiotherapy （3-DCRT） for elderly patient with esophageal carcinoma. Methods 51 elderly patient with esophageal carcinoma receiving 3-DCRT, the prescribed doses ranged from 52 Gy to 60 Gy with 2 Gy per fraction, 1 fraction per day and 5 fraction per week （prescribed at the 90% isodose）. Results CT or GI was performed 1-3 months after radiotherapy showed that CR 7.8%, PR 78.4%, SD 11.8%, RR （CR＋PR） 86.2%. The 1-, 2- and 3-year overall survival rates were 53.3%, 31.1% and 19.5%, respectively, with a median survival duration of 16.0 months. No serious complication was observed in the course. Conclusions 3-DCRT is an effective and safe treatment modality, for elderly patient with esophageal carcinoma, improving life quality and prolonging survival time as well.