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目的初步探讨后程加速超分割放射治疗对缩窄型食管癌的近期疗效和毒性。方法对35例经胃镜病理及X线钡餐证实的缩窄型食管癌患者实施后程加速超分割放疗。前4周常规放疗,照射1次/d,DT 40 Gy,20次,后2~3周采用加速超分割放疗,照射2次/d,DT 1.5 Gy/次,间隔6~8 h,DT30~36 Gy,总剂量DT 70~76 Gy。以放疗结束时临床症状及放疗结束后1个月的食管钡餐片作为评价依据。结果 (1)22例在治疗结束时临床症状获得明显改善,短期症状缓解率达62.85%。(2)1个月后X线钡餐显示完全缓解(CR)6例,部分缓解(PR)19例,无缓解(NR)8例,近期有效率为71.43%。(3)毒副反应主要表现为急性放射性食管炎、放射性气管炎,其中急性放射性食管炎Ⅲ度3例,Ⅰ~Ⅱ度10例,放射性气管炎I度5例。结论对于缩窄型食管癌患者采用后程加速超分割放射治疗是可行的,能够提高局部控制率,毒副反应可以耐受,远期疗效值得进一步探讨和研究。
Objective To investigate the short-term efficacy and toxicity of late-accelerated hyperfractionation radiotherapy for narrowing esophageal cancer. Methods A retrospective study of 35 cases of patients with esophageal cancer confirmed by gastroscopic pathology and X-ray barium meal was performed. The first four weeks of conventional radiotherapy, irradiation 1 times / d, DT 40 Gy, 20 times, 2 to 3 weeks after accelerated hyperfraction radiotherapy, irradiation 2 times / d, DT 1.5 Gy / time interval 6 ~ 8 h, DT30 ~ 36 Gy, total dose DT 70 ~ 76 Gy. The clinical symptoms at the end of radiotherapy and 1 month after radiotherapy barium meal as the basis for evaluation. Results (1) The clinical symptoms of 22 cases were significantly improved at the end of treatment, the short-term symptom relief rate was 62.85%. (2) One month later, barium meal showed complete remission (CR) 6 cases, partial remission (PR) 19 cases, no remission (NR) 8 cases, the recent effective rate was 71.43%. (3) Toxic and side effects mainly manifested as acute radiation esophagitis, radiation bronchitis, including acute esophagitis grade Ⅲ in 3 cases, Ⅰ ~ Ⅱ degree in 10 cases, I degree 5 cases of radioactive bronchitis. Conclusions It is feasible to use late-course accelerated hyperfraction radiotherapy for patients with narrow-typed esophageal cancer to improve the local control rate and tolerate the side effects. The long-term efficacy deserves further exploration and research.