| 80岁以上老年人食管癌适形调强放疗与常规放疗疗效比较 |
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| 引用本文： | 魏洁,王军,吕星旺. 80岁以上老年人食管癌适形调强放疗与常规放疗疗效比较[J]. 中华全科医学, 2016, 14(9): 1488-1491. DOI: 10.16766/j.cnki.issn.1674-4152.2016.09.019 |
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| 作者姓名： | 魏洁 王军 吕星旺 |
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| 作者单位： | 滁州市第一人民医院西大街院区肿瘤放疗科, 安徽 滁州 239001 |
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| 基金项目： | 安徽省“十二五”临床重点专科建设计划首批建设项目(01T50) |
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| 摘 要： | 目的 探讨适形调强放疗与常规放疗治疗80岁以上老年人食管癌的疗效及毒副反应。 方法 回顾性分析2009年11月—2012年10月收住肿瘤放疗科并完成根治性放射治疗的80岁以上食管癌患者共41例。其中适形调强放疗18例，常规放疗23例，总处方剂量DT 48～69 Gy，24～34次完成。统计2组的近期、远期疗效、症状缓解率及毒副反应。采用Kaplan-Meier法和Log-rank法分析比较生存率。 结果 适形调强组、常规放疗组近期有效率分别为88.9%、60.9%(χ2=4.308，P=0.044)；中位生存期分别为12个月和9个月，其1年、3年生存率分别为44.4%(8/18)、21.7%(5/23)和16.7%(3/18)、4.3%(1/23)(χ2=5.919，P=0.015)。适形调强组症状缓解率83.3%(15/18)，常规放疗组症状缓解率82.6%(19/23)，2组比较差异无统计学意义(χ2=0.004，P=0.951)。在毒副反应方面，主要不良反应为Ⅰ～Ⅱ度放射性食管炎、放射性肺炎、骨髓抑制及食欲减退，2组均未出现3级以上放疗反应。 结论 对于80岁以上食管癌患者，放射治疗是一种安全有效的治疗手段，采用适形调强放射治疗可以进一步提高疗效。
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| 关 键 词： | 老年患者 食管肿瘤 放射疗法 适形调强放疗 |
| 收稿时间： | 2016-02-06 |
Comparison of therapeutic effects of intensity modulated radiation therapy and conventional radiotherapy for esophageal cancer in the elderly over 80 years old |
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| Affiliation: | Department of Radiotherapy, the First People's Hospital of Chuzhou, Chuzhou, Anhui 239001, China |
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| Abstract: | Objective To investigate the efficacy and side effects of intensity modulated radiation therapy(IMRT) and conventional radiotherapy(CRT) in the treatment of esophageal carcinoma in older patients aged over 80 years. Methods The clinical data of 41 cases of senile esophageal carcinoma (aged over 80 years) undergoing radiotherapy in our hospital between November,2009 and October,2012 were reviewed retrospectively.18 cases received IMRT and 23 cases received CRT with a total radiation dose of 48-69 Gy and 24-34 fractions.The short-term,long-term efficacy,symptom relief rate,toxic and side effects were statistically analyzed,and Kaplan-Meier method was used to analyze the survival rate,Log-rank test was used to evaluate the difference between the groups. Results The short-term response rates in the IMRT group and the CRT group were 88.9% and 60.9% respectively,the difference was statistical significant(χ2=4.308,P=0.044);The Median Survival Times were 12 months and 9 months for each;The 1- and 3- survival rates were 44.4%(8/18),21.7%(5/23)and 16.7%(3/18),4.3%(1/23)and had statistical significance(χ2=5.919,P=0.015).The symptom relief rates of the IMRT group and the CRT group were 83.3%(15/18) and 82.6%(19/23),respectively,and there was no statistical significance(χ2=0.004,P=0.951).The adverse effect mainly included radioactive esophagitis,pneumonia,myelo suppression and anorexia (grade 1-2).There was no radio therapeutic toxic and side effects over Level 3 in both groups. Conclusion Radiotherapy is a safe and efficient way for the aged esophageal carcinoma patients over eighties.IMRT can improve the therapeutic efficacy. |
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