后程加速超分割三维适形放疗对食管癌根治术后纵膈淋巴结转移患者的影响

The Curative Effects of Late Course Accelerated Hyperfractionated Combining Three-dimensional Conformal Radiotherapy for Treatment of Mediastinal Lymph Node Metastasis after Radical Resection of Esophageal Carcinoma

目的探讨后程加速超分割三维适形放疗对食管癌根治术后纵膈淋巴结转移患者的疗效及免疫功能的影响。方法选择2012年7月至2015年12月本院收治的食管癌术后纵膈淋巴结转移患者80例,按照随机数字法分为对照组和观察组,各40例。对照组行三维适形调强放疗,观察组在对照组基础上行后程加速超分割放疗,统计两组的中位生存时间,比较干预后3个月两组患者的生活质量和血清Ig水平,并评价两组的整体治疗效果。结果观察组治疗有效率显著高于对照组(P<0.05);观察组中位生存时间显著长于对照组(P<0.05),生活质量显著优于对照组(P<0.05);干预后观察组的血清Ig M、Ig G和Ig A水平均高于对照组,差异有统计学意义(P<0.05)。结论后程加速超分割三维适形放疗可有效延长食管癌术后纵膈转移患者生存时间、促进血清Ig含量增高,进而提高患者生活质量,改善临床治疗效果。

Objective To explore the effects of late course accelerated hyperfractionated three-dimensional conformal radiotherapy for treatment of mediastinal lymph node metastasis after radical resection of esophageal carcinoma. Methods 80 patients with mediastinal lymph node metastasis after radical resection of esophageal carcinoma were chosen between July 2012 and December 2015 in our hospital. They were divided into two groups randomly, each group 40 patients. The control group was given three-dimensional conformal radiotherapy, while the observation group was given late course accelerated hyperfractionated on the basis of three-dimensional conformal radiotherapy. Survival time, Humoral immune function and the life quality of the two groups were analyzed after three months＇ treatment. Results The ef- fective rate of observation group was significantly higher than that of control group （P 〈 0.05）. In observation group, the median survival time was significantly longer than in control group （P〈0.05）. The quality of life in observation group was significantly better than in control group （P 〈 0.05）. IgM, IgG and IgA in observation group after treatment were higher than in control group （P 〈 0.05）. Conclusion Late course accelerated hyperfractionated combining three-dimensional conformal radiotherapy treatment can prolong the survival time of esophageal carcinoma patients and improve their immune function and quality of life.