食管癌同步加量调强放疗与常规调强放疗临床对照研究

摘要

目的：比较局部晚期食管癌同步加量调强放疗与常规调强放疗的毒副反应和疗效。方法将80例局部晚期食管鳞癌患者按照不同照射方式，使用数字表法随机分成2组：同步加量组、常规调强组。2组靶区勾画相同，照射方式的实施不同，同步加量组：PTV 照射54 Gy 与 PGTV 照射60 Gy 单个治疗计划30次同步完成。常规调强组：第1个计划照射 PTV 50 Gy/25次后，再照射 PGTV 10 Gy/5次。2组均同期给予紫杉醇联合顺铂每周方案化疗6周。观察2组在毒副反应、近期疗效、远期疗效方面的差异。结果同步加量组和常规调强组在急性毒副反应、近期疗效方面比较差异均无统计学意义（P 均﹥0.05）。2组1、2 a 无复发生存率分别为81.7％、73.6％和86.3％、80.1％，比较差异无统计学意义（P ﹥0.05）；1 a 年生存率分别为85.9％和87.7％，比较差异无统计学意义（P ﹥0.05）。结论局部晚期食管癌放疗时采用同步加量照射与选择淋巴引流照射疗效相同，毒副反应相近，但更简便易行，食管癌放疗时采用同步加量调强放疗是可行的。%Objective To compare the toxicities and curative effect of simultaneous integrated boost intensity modu-lated radiotherapy and conventional intensity modulated radiotherapy for local advanced esophageal carcinoma. Meth-ods Eighty patients with local advanced esophageal carcinoma were randomly divided into two groups according to random number table:the simultaneous integrated boost intensity modulated radiotherapy group and the conventional intensity modulated radiotherapy group. PTV irradiation 54 Gy/ 30 times and PGTV 60 Gy/ 30 times will be treated in one plan. Both groups were given paclitaxel combined with cisplatin chemotherapy for 6 weeks. The toxicities,short-term curative effect and long-term curative effect were compared between the two groups. Results There was no difference in the acute toxicities between the two groups(P ﹥ 0. 05). The 1-,2-year recurrence-free survival rates were 81. 7% , 73. 6% and 86. 3% ,80. 1%(P ﹥ 0. 05). The 1-year survival rates were 85. 9% and 87. 7%(P ﹥ 0. 05). Conclusion There is no significant difference in the acute toxicities or curative effect between the two groups. In the treatment of locally advanced esophageal cancer,it is feasible to use simultaneous integrated boost intensity modulated radiotherapy.