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目的探讨食管癌治疗后纵隔淋巴结转移灶三维适形放射治疗的意义和效果。方法回顾性分析46例食管癌治疗后发生纵隔淋巴结转移的患者。其中术后转移的有25例,纵隔淋巴结转移复发平均时间为19.2月;放疗后转移的有21例,复发平均时间为14.3月。食管癌术后的病例先采用常规放疗,DT:40~44 Gy/20~22次,然后采用适形放疗,总剂量达60~68 Gy。放疗后的病例均采用适形放疗,CTV为2~2.5 Gy/次,5次/周,每次3~5个照射野投照,总剂量60~68 Gy。结果治疗后3个月复查,术后病灶的有效率达88.0%,放疗后的有效率达71.4%,比效结果有显著性差异(P<0.05)。放射性肺部症状,术后和放疗后分别为68.0%和71.4%,比效结果无差异(P>0.05)。放射性食管症状,术后和放疗后分别为24.0%和66.6%,比效结果有显著性差异(P<0.05)。结论食管癌治疗后发生纵隔淋巴结转移进行三维适形放射治疗可以明显提高局部控制率,且副作用小。
Objective To investigate the significance and effect of three-dimensional conformal radiotherapy of mediastinal lymph node metastasis after esophageal cancer treatment. Methods A retrospective analysis of 46 patients with esophageal cancer after mediastinal lymph node metastasis occurred. There were 25 cases of postoperative metastasis, the average time of mediastinal lymph node metastasis recurrence was 19.2 months; 21 cases of metastasis after radiotherapy, the average recurrence time was 14.3 months. The cases of esophageal cancer after conventional radiotherapy, DT: 40 ~ 44 Gy / 20 ~ 22 times, then the use of conformal radiotherapy, a total dose of 60 ~ 68 Gy. Radiotherapy after radiotherapy are conformal radiotherapy, CTV is 2 ~ 2.5 Gy / time, 5 times / week, each time 3 ~ 5 irradiation field projection, the total dose of 60 ~ 68 Gy. Results Three months after treatment, the effective rate of postoperative lesions was 88.0%, and the effective rate after radiotherapy was 71.4%. There was a significant difference (P <0.05). Radiation lung symptoms, postoperative and radiotherapy were 68.0% and 71.4%, respectively, and there was no significant difference between the two groups (P> 0.05). Radiation esophageal symptoms, postoperative and postoperative radiotherapy were 24.0% and 66.6%, respectively, and the results were significantly different (P <0.05). Conclusion Three-dimensional conformal radiotherapy of mediastinal lymph node metastasis after esophageal cancer treatment can significantly improve the local control rate, and the side effects are small.