Objective To analyze the diagnosis value of three-dimensional conformal radiotherapy (3DCRT) for esophageal cancer by comparing the differences in doses and clinical prognoses between 3DCRT and conventional radiotherapy.Methods Selected from patients admitted in the Affiliated Hospital of North Sichuan Medical College,90 patients diagnosed of esophageal cancer and received the first radiotherapy were enrolled in the study,and divided into conventional radiotherapy group and 3DCRT group according to the design of radiotherapy plans (each group of 45 cases).The differences in dose indexes in target area,normal tissue doses in heart and lung,clinical effect,survival rate and irradiation security between the two groups were compared.Results The D95％,D50％,D98％,,D2％,V95％ and conformal index in 3DCRT group were (4 654.43±125.41) cGy,(4 011.42±114.93) cGy,(4 735.69±102.17) cGy,(6 325.98±214.65) cGy,(465.35±65.36) cm3,and 0.41±0.04,respectively,significantly higher than those in conventional radiotherapy group (P＜0.05).The body~％,homogeneity index,lung dose and heart dose in 3DCRT group were (133.15±136.48) cm3,0.39±0.12,(1 013.52±112.47) cGy,and (3 465.82t169.84) cGy,respectively,significantly lower than those in conventional radiotherapy group (P＜0.05).The total clinical benefit rate in 3DCRT group was 77.78％,obviously higher than that in conventional radiotherapy group (62.22％).3DCRT group also showed significantly lower incidences of bone marrow suppression (15.56％),gastrointestinal reactions (20.00％),radiation esophagitis (22.22％),and radiation pneumonia (31.11％),compared with conventional radiotherapy group (P＜0.05).After therapy,1-year survival rate,2-year survival rate,and the duration of disease free survival in 3DCRT group were 88.89％,57.78％ and (36.14±4.13) months,respectively,superior to those in conventional radiotherapy group (P＜0.05).Conclusion Compared with conventional radiotherapy,3DCRT improveds the dose distribution homogeneity in target area and protects the surrounding normal tissues,with remarkable advantages in dosimetric distribution and clinical effect.%目的:观察三维适形放疗(3DCRT)与常规放疗治疗食管癌的剂量学以及临床预后的差异性,分析3DCRT治疗食管癌的价值.方法:回顾选取本院确诊并首次接受放化治疗的食管癌患者共90例作为研究对象,根据放疗设计方案分为常规放疗组和3DCRT组,每组各45例,对比分析两组间在靶区剂量学指标、心肺正常组织受量、临床疗效、生存情况以及放疗安全性方面的差异.结果:(1)3DCRT组的靶区D95％为(4 654.43±125.41)cGy、D50％为(4011.42±114.93)cGy、D98％为(4 735.69±102.17) cGy、D2％为(6 325.98±214.65)cGy、V95％为(465.35±65.36)cm3以及CI为0.41±0.04,显著高于常规放疗组(P＜0.05);而组间body95％为(133.15±136.48)cm3、HI为0.39±0.12、肺接受剂量为(1 013.52±112.47) cGy、心脏接受剂量为(3 465.82±169.84)cGy,显著低于常规放疗组(P＜0.05).(2)3DCRT组总临床收益率(77.78％)明显高于常规放疗组(62.22％),3DCRT组骨髓抑制(15.56％)、胃肠道反应(20.00％)、放射性食管炎(22.22％)、放射性肺炎(31.11％)发生率明显低于常规放疗组,组间差异显著(P＜0.05);3DCRT组患者在放化疗后的1年生存率(88.89％)、两年生存率(57.78％)、中位无瘤存活期限为(36.14±4.13)月,明显优于常规放疗组(P＜0.05).结论:与常规放疗相比,3DCRT技术具有肿瘤靶区剂量分布均匀、保护周围正常组织的优点,在剂量学分布、临床疗效方面具有显著优势.
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