同步整合加量调强放射治疗原发性食管癌的临床疗效

Clinical efficacy of simultaneous integrated boost intensity-modulated radiation therapy for primary esophageal cancer

目的：评价同步整合加量调强放射治疗（SIB-IMRT）技术治疗原发性食管癌的近期疗效及不良反应。方法32例原发性食管癌患者均采用5野或7野的 SIB-IMRT 技术进行放射治疗。肿瘤靶区（GTV）220 cGy／F，总剂量6600 cGy／30F；临床靶区（CTV）单次剂量180 cGy，总剂量5400 cGy／30F。结果32例原发性食管癌患者均按计划完成放射治疗。放射治疗结束时有26例患者食管病灶完全缓解，完全缓解率为81％（26／32）；4例部分缓解，部分缓解率为13％。右肺 V20为9％-21％，左肺 V20为11％-23％。其中Ⅰ-Ⅱ级放射性食管炎共11例，发生率为34％。Ⅰ-Ⅱ级放射性气管炎6例，发生率为19％，无Ⅲ级以上急性不良反应发生。结论SIB-IMRT 技术治疗原发性食管癌疗效好，不良反应可耐受。

Objective To evaluate the short-term efficacy and adverse events of simultaneous inte-grated boost intensity-modulated radiation therapy （SIB-IMRT）in the treatment of primary esophageal cancer. Methods Thirty-two patients diagnosed with primary esophageal cancer were treated with 5-or 7-field SIB-IM-RT.Gross target volume （GTV）was given at a dose of 220 cGy/F with a total dose of 6 600 cGy/30F.Clini-cal target volume （CTV）was given at a single dose of 180 cGy/F with a total dose of 5 400 cGy/30F.Results All 32 patients successfully completed the chemotherapy.The complete response rate was 81% （26 /32）and partial response rate was 13% （4 /32）.The V20 of the left lung ranged from 11% to 23% and 9%-21% for the V20 of the right lung.Eleven patients （34%）presented with grade Ⅰ-Ⅱ radiation esophagitis and 6 （19%）had grade Ⅰ-Ⅱ radiation tracheitis.Conclusions SIB-IMRT is an effective therapy in treating pri-mary esophageal cancer and the adverse events are tolerable.