食管癌放疗后局部复发再程调强放疗的疗效和安全性分析

Efficacy and Safety of Intensity-modulated Radiotherapy for Local Recurrence of Esophageal Cancer after Radiotherapy

目的对食管癌(COE)放疗后局部复发再程调强放疗的疗效及安全性进行探讨。方法研究纳入我院2019年4月至2022年3月收治的食管癌根治性放疗后局部复发患者100例,所有患者均给予再程调强放疗并观察治疗效果和安全性。结果患者经治疗后,54例患者表现为治疗有效,有效率为54%;以及32例患者出现有不良反应,发生率为32%,其中包括2级放射性食管炎11例,占比11%,2级血液毒性反应10例,占比10%,3级放射性肺炎7例,占比7%,以及食管穿孔4例,占比4%。进行随访发现,患者的一年生存率为57%,二年生存率为43%,以及三年生存率为29%。与此同时,患者经治疗之后,其胸上、中、下段的食管静息压和吞咽压均呈现出了大幅度的降低,前后差异有统计学意义(P<0.05)。结论再程强调放疗近期疗效显著,不仅能够帮助患者大幅度改善食管静息压和吞咽压,还能够帮助患者大幅度减少不良反应的发生,从而促使患者获得更为良好的治疗效果,因而其具有较高的临床推广和应用价值。

Objective To investigate and analyze the efficacy and safety of intensity modulated radiotherapy for local recurrence of esophageal cancer(COE)after radiotherapy.Methods From April 2019 to March 2022,100 patients were studied,and all patients were treated with re-course intensitymodulated radiotherapy,and then the efficacy and safety were observed and analyzed.Results After treatment,54 patients showed that the treatment was effective,and the effective rate was 54%;And 32 patients had adverse reactions,with an incidence of 32%,including 11 cases of grade 2 radiation esophagitis,accounting for 11%,10 cases of grade 2 blood toxicity reaction,accounting for 10%,7 cases of grade 3 radiation pneumonia,accounting for 7%,and 4 cases of esophageal perforation,accounting for 4%.Follow-up showed that the one-year survival rate was 57%,the two-year survival rate was 43%,and the three-year survival rate was 29%.At the same time,after treatment,the esophageal resting pressure and swallowing pressure in the upper,middle and lower thoracic segments of the patients showed a significant decrease,with a statistically significant difference before and after treatment(P<0.05).Conclusion The re-process emphasizes that radiotherapy has a significant short-term effect,which can not only help patients to significantly improve the esophageal resting pressure and swallowing pressure,but also help patients to significantly reduce the occurrence of adverse reactions,so as to promote patients to obtain better treatment results,so it has high clinical promotion and application value.