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目的观察IMRT/3DCRT配合锎252(Cf252)中子腔内放射治疗中晚期食管癌的疗效及不良反应。方法收集我院2007年1月～2011年2月间收治的38例经病理检查证实食管鳞癌的患者,临床分期II、III、IV期分别为14、19、5例,全部患者KPS评分≥80分,无远处转移,均为首程放疗,放疗采用体外照射序贯腔内模式。先采用6MV X线直线加速器IMRT/3DCRT技术照射,95%等剂量线覆盖95%PTV体积,95%PTV≥50Gy,然后采用ZH-1000型Cf252中子后装治疗机治疗,总吸收剂量10～16Gy。放疗后3个月进行近期疗效评估。结果进食哽噎症状明显改善,35例症状完全消失,3例好转。急性毒副反应以放射性食管炎为主。I级放射性食管炎发生率为23.7%(9/38),II级为7.9%(3/38)。近期疗效评价有效率(CR+PR)92.1%,全组1、2年生存率分别为68%、19%。结论 IMRT/3DCRT结合Cf252中子照射是安全有效的治疗方法,具有一定的临床应用前景。
Objective To observe the efficacy and adverse reactions of IMRT / 3DCRT combined with 锎 252 (Cf252) neutron radiotherapy for advanced esophageal cancer. Methods Thirty-eight patients with pathologically confirmed esophageal squamous cell carcinoma were enrolled in our hospital from January 2007 to February 2011. The clinical stage II, III and IV were 14, 19, and 5 cases respectively. The KPS scores of all patients ≥ 80 points, no distant metastasis, are the first course of radiotherapy, radiotherapy using in vitro irradiation sequential intraluminal mode. First use of 6MV X-ray linear accelerator IMRT / 3DCRT technology, 95% isodose line covering 95% PTV volume, 95% PTV ≥ 50Gy, and then using ZH-1000 Cf252 neutron afterloading treatment machine treatment, the total absorbed dose of 10 ~ 16Gy. Three months after radiotherapy for short-term efficacy evaluation. Results Symptoms were significantly improved after eating 35 cases of symptoms disappeared completely, 3 cases improved. Acute side effects of radiation esophagitis based. Grade I esophagitis rates were 23.7% (9/38) and grade II 7.9% (3/38). The effective rate of immediate curative effect evaluation (CR + PR) was 92.1%, and the overall 1, 2 year survival rates were 68% and 19% respectively. Conclusion IMRT / 3DCRT combined with Cf252 neutron irradiation is a safe and effective treatment and has certain clinical application prospects.