72例食管癌三维适形放疗（3D-CRT）临床疗效与毒性分析

目的：三维适形放射治疗（3D-CRT）目前已广泛运用于食道癌的放射治疗,能在一定程度提高肿瘤剂量并减少正常组织照射.本文试图分析72例食管癌3D-CRT的疗效与毒性,旨在为食管癌的治疗提供更多参考依据.方法： 回顾性分析总结我院2004年4月～2006年9月采用3D-CRT放疗的72例食道癌患者,并随机抽取同时期常规X线定位技术放疗的72例食管癌患者作对照,两组在年龄、性别、分期、分段方面未见统计学差异.3D-CRT组肿瘤剂量66～72GY（常规分割,中位剂量70Gy）,常规组肿瘤剂量60～68Gy（常规分割,中位剂量64Gy）.观察两组患者的近远期疗效与毒副反应.结果：3D-CRT治疗组有效率（CR＋PR）高于对照组（分别为90.2%和69.4%,P〈 0.05）.3D-CRT 组与常规组1、2、3年局控率分别为75.0%、61.0%、42.9%以及55.6%、49.2%、35%,经Log-rank法检验1年局控率有统计学差异（P〈0.05）.1、2、3年生存率分别为74.6%、58.2%和41.6%以及66.5%、42.1%和35.6%,经Log-rank法检验2年生存率有统计学差异（P〈0.05）.血液学的近期,以及食道、肺的近远期毒性均未见统计学差异（P〈0.05）.结论：食管癌采用3D-CRT放疗提高肿瘤剂量后有助于改善肿瘤局部控制并提高生存,而近期毒性未见明显增加,可见具有较好的治疗获益.

72 example esophagus cancer three dimensional suitable shape radiotherapy （3D-CRT） clinical curative effect and the toxicity analyze

Objective： Three dimensional suitable shape radiotherapy （3D-CRT） at present has widely utilized in carcinoma oesophagi radiotherapy,can enhance the tumor dosage in certain degree and reduce the normal tissue to shine. This article attempts to analyze 72 example esophagus cancer 3D-CRT the curative effect and the toxicity,is for the purpose of providing the more reference for esophagus cancer treatment. Methods：The review analysis summarizes 72 example carcinoma oesophagi patient who my courtyard in April,2004 -2006 years in September uses the 3D-CRT radiotherapy,and the draw an item at random makes the comparison with the time convention X localization technology radiotherapy 72 example esophagus cancer patient,two groups in the age,the sex,the partition aspect have not seen by stages statistics difference. 3D-CRT group tumor dosage 66 -72GY （conventional division,position dosage 70Gy）, conventional group tumor dosage 60- 68Gy （conventional division, position dosage 64Gy）. Observes two group of patient＇s near forward curative effects and the poisonous side reaction. Results：3D-CRT treatment group effectiveness （CR＋ PR） is higher than the control group （respectively is 90.2 % and 69.4 %,P〈 0.05）. The 3D-CRT group and the conventional group 1,2,3 years bureau controls rate respectively is 75.0% ,61.0% ,42.9% as well as 55.6% ,49.2% ,35% ,examines I year bureau after the Log-rank law to control rate has statistics difference （P〈0.05）. lst,2,3 years survival rate respectively is 74.6% ,58.2% and 41.6% as well as 66.5% ,42.1% and 35. 6% ,examines 2 years survival rate after the Log-rank law to have statistics difference （P〈0.05）. The hematology near future,as well as the esophagus, the lung near forward toxicity has not seen statistics difference （P〈0.05）. Conclusion：After esophagus cancer uses the 3D-CRT radiotherapy to enhance the tumor dosage to be helpful in the improvement tumor local control and enhances the survival, but the short-term toxicity has not seen the obvious increase, obviously has the good treatment benefit.