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食管癌术后纵隔转移灶三维适形放射治疗的疗效 被引量:31

Three-dimmentional conformal radiotherapy for mediastinal metastasis from esophageal carcinoma after surgery
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摘要 目的 探讨胸段食管癌根治术后纵隔转移灶三维适形放射治疗的意义和效果。方法 回顾性分析 6 3例食管癌根治术后 3~ 2 0个月发生纵隔转移患者。转移灶直径 <2cm 10例 ,2~ 3cm33例 ,>3cm 2 0例。伴有颈淋巴结转移 9例。 6 3例中右上纵隔 2 7例 ,左上纵隔 16例 ,中上纵隔 2 0例。 6 3例中未接受过放射治疗的 5 2例先常规分割放射治疗 4 0Gy ,后重新定位再次做治疗计划 ,新计划 3.0Gy/次 ,5次 /周 ,照射总剂量 6 4~ 70Gy。原来接受过放射治疗的患者仅给予 5 0Gy,不再重新定位。结果 治疗后 1个月复查 ,病灶达CR者 2 7例 ,病灶达PR者 30例 ,无进展病例。 1、2、3年生存率分别为 75 %、4 3%、15 %。结论 食管癌根治术后发生纵隔转移进行三维适形放射治疗可以明显提高局部控制率和生存率 。 Objective To evaluate the effect of 3-dimmentional conformal radiotherapy (3-DCRT) for mediastinal metastasis from esophageal carcinoma after surgery.Methods Sixty-three such patients were treated by 3-DCRT. Tumor diameter was: <2?cm 10 patients, 2~3?cm 33 patients and >cm 20 patients. Positive supraclavicular lymph node was found in 9 patients. The number of tumor at the upper right, upper left and upper median mediastinum was 27, 27 and 20. All patients received 3-DCRT to the dose of 40?Gy (2?Gy/f, 5f/w), after resetting of portals, the dose was boost to 64~70?Gy by 3?Gy/f, 5f/w. Dose of the patients who had been irradiated was boosted to 50?Gy without further positioning. Results Complete response rate and partial response rate were 43% and 48% one month after the treatment was concluded,with no progression of disease. The 1-, 2- and 3-year survival rates were 75%, 43% and 15%. Conclusions Three-dimmentional conformal radiotherapy, with little side-effects, can markedly improve the local control rate and suvival rate of patients with mediastinal metastasis from esophageal carcinoma after surgery.
出处 《中华放射肿瘤学杂志》 CSCD 北大核心 2004年第4期268-269,共2页 Chinese Journal of Radiation Oncology
关键词 食管癌 术后 纵隔转移灶三维适形放射治疗 疗效观察 Esophageal neoplasms Neoplasm metastasis Radiotherapy,conformal Prognosis
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