不同放疗方法对食管癌患者近期疗效的影响

Efficacy of different radiotherapy methods on the short term prognosis of esophageal cancer patients

目的观察不同放疗方法对食管癌患者近期疗效的影响。方法选取2012年3月至2014年2月间收治的112例食管癌,随机数字表法分为试验组和对照组,每组56例,试验组患者采用三维适形放疗,对照组患者采取常规放疗。观察两组患者1、2年局部控制率及生存率、不良反应发生率及治疗满意率。结果试验组患者1、2年生存率分别为85.7%和58.9%,显著高于对照组的67.9%和37.5%,差异有统计学意义(P<0.05)。试验组患者1、2年局部控制率分别为69.6%和48.2%,显著高于对照组的50.0%和28.6%,差异有统计学意义(P<0.05)。试验组患者放射性肺炎发生率为3.6%,显著低于对照组的16.1%,差异有统计学意义(P<0.05)。试验组患者放射性食管炎发生率为26.9%,显著高于对照组的10.7%,差异有统计学意义(P<0.05)。试验组患者治疗满意率为96.4%,显著高于对照组的82.1%,差异有统计学意义(P<0.05)。结论与常规放疗比较,三维适形放疗患者生存率及局部控制率高,放射性肺炎发生率低,三维适形放疗放射性食管炎发生率较高与肿瘤区域高剂量分布有关,尚可耐受,患者对治疗满意度较高,可延长患者生命,减少不良反应,增加治疗依从性。

Objective To observe the efficacy of different radiotherapy methods on the short term prognosis of esophageal cancer patients. Methods From March 2012 to February 2014,112 esophageal cancer patients were enrolled in the study and randomly divided into two groups： the experimental group and the control group,56 cases in each group. The experimental group accepted three-dimensional conformal radiotherapy and the control group adopted conventional radiotherapy. 1-yr,2-yr local control rate and survival rate and toxicity and treatment satisfaction were compared between the two groups. Results 1-yr,2-yr survival rates of the experimental group were 85. 7% and 58. 9%,significantly higher than those of the control group（ 67. 9%,37. 5%）,with significant differences（ P〈0. 05）; 1-yr,2-yr local control rates of the experimental group were 69. 6% and 48. 2%,significantly higher than those of the control group（ 50. 0%,28. 6%）（ P〈0. 05）. The radiation pneumonitis occurrence rate of the experimental group was 3. 6%,significantly lower than that of the control group（ 16. 1%）（ P〈0. 05）. The radiation esophagitis incidence rate of the experimental group was 26. 9%,significantly higher than that of the control group（ 10. 7%）（ P〈0. 05）. The satisfaction rate of the experimental group was 96. 4%,significantly higher than that of the control group（ 82. 1%）（ P〈0. 05）. Conclusions In the treatment of esophageal cancer patients,compared with conventional radiotherapy,3D conformal radiotherapy could achieve high survival rate and local control rate. At the same time,it also can reduce the incidence of radiation pneumonitis,and 3D conformal radiotherapy radiation esophagitis is related to the higher incidence of tumor region of high dose distribution. The patients＇ satisfaction is higher and could prolong life,reduce the adverse reaction,and increase treatment compliance. And it is worthy of clinical application.