三维适形放疗治疗32例食管癌γ-刀放疗后复发的近期疗效分析

The Analysis of Clinical Effect on 32 Cases with Recurrent Esophageal Carcinoma afterγ-knife Radiotherapy Treated by Three-dimensional Conformal Radiotherapy

目的:研究三维适形放疗治疗32例食管癌γ-刀放疗后复发的可行性,观察其近期疗效与安全性。方法:对32例食管癌γ-刀放疗后复发患者实施三维适形放疗,评价急性放疗反应及近期疗效。结果:28例患者顺利完成放疗计划,初次放疗与再次放疗中位间隔时间7月,再次放疗中位剂量57.6Gy,近期完全缓解率9%,部分缓解率69%,稳定9%,进展13%,总治疗总有效率为78%。患者急性放射性食管炎发生率1-2级16%(5/32),3-4级31%(10/32);急性放射性肺炎发生率1-2级16%(5/32),3-4级9%(3/32);骨髓抑制的发生率为47%,1-2级37.5%(12/32),3-4级9.5%(3/32),急性心脏损伤发生率3%,1-2级3%(1/32),3-4级0%(0/32)。结论:三维适形放疗治疗γ-刀放疗后复发食管癌的近期疗效较好,患者可耐受,晚期并发症及疗效有待进一步观察。

Objective： To observe the clinical effect of recurrent esophageal carcinoma by three-dimensional conformal radiotherapy. Methods： 32 cases treated with three-dimensional conformal radiotherapy after recurrence of esophageal γ-knife radiotherapy, and evaluating the acute radiation reaction and short-term effect. Results： 28 patients had successfully completed the treatment. The recently complete response rate was 9%; the partial response rate was 69%; stable disease was 9%; the progressive disease 13%. According to the RTOG grading, the rate of acute radiation esophagitis was 16% （5/32）for 1-2 grade, and 31% （10/32）for 3-4 grade; the rate of acute radiation pneumonitis is 16% （5/32） for 1-2 grade, 9% （3/32） for 3-4 grade; the rate of acute cardiac injury was 6% （2/32） for 1-2 grade, and 0（0/32） for 3-4 grade. Conclusion： The three-dimensional conformal radiotherapy was effective to treat recurrent esophageal carcinoma, and had low incidence rate of short-term complications.