蔡璐　何静　钟丽婷　郭小青

[关键词] 三维腔内后装;外照射;食管癌;放射性肺炎;生存质量

[中图分类号] R735.1          [文献标识码] B          [文章编号] 1673-9701（2021）23-0075-04

Application and effect of three dimensional intracavitary retrofitting combined with external irradiation in esophageal cancer

CAI Lu   HE Jing   ZHONG Liting   GUO Xiaoqing

Department of Oncology， Ganzhou People′s Hospital in Jiangxi Province， Ganzhou   341000， China

[Abstract] Objective To analyze the application and effect of three dimensional intracavitary retrofitting combined with external irradiation in esophageal cancer. Methods A total of 70 patients with esophageal cancer in our hospital from January to December 2018 were selected and randomly divided into two groups with 35 patients in each group. The observation group was treated with conformal intensity modulated radiotherapy （IMRT） + three dimensional intracavitary retrofitting radiotherapy， while the control group was treated with simple IMRT. Patients were treated with concurrent chemotherapy （paclitaxel + nedaplatin every 3 weeks）. Three months after the end of treatment， the total effective rates， quality of life and complication rates were compared between the two groups. Results The effective rate of the observation group was  71.43%， which was higher than 51.43% of the control group， and the difference between the two groups was statistically significant （P<0.05）. The quality of life of the observation group was（88.56±3.21） points which was higher than（78.72±3.51） points of the control group， and the difference between the two groups was statistically significant（P<0.05）. The total complication rate of the observation group was 11.43%，which was lower than 45.71% of the control group， and the difference between the two groups was statistically significant（P<0.05）. Conclusion Three dimensional intracavitary retrofitting radiotherapy combined with external irradiation not only improves the short-term efficacy in treating tumor， but also reduces the incidence of radiation esophagitis， radiation pneumonia， heart injury and spinal cord injury， thereby alleviating the pain of patients and improving the quality of life of patients.

[Key words] Three dimensional intracavitary retrofitting; External irradiation; Esophageal cancer; Radiation pneumonitis; Quality of life

根據最新数据统计，食管癌居我国发病率第六位，为第四大致死肿瘤，我国中部地区和东部地区是食管癌的高发地区。而且90%的食管癌患者就诊时即为中晚期，失去手术机会，放疗为此类患者的重要治疗手段，然而，常规分割外照射的5年生存率仅为10%，放疗后的失败原因主要为局部复发，提高食管癌放射治疗的局部控制率是提高疗效的关键。由于剂量学分布的特征，后装腔内放疗可以加强对肿瘤的局部控制而不增加对正常组织毒副作用，且CT定位的三维近距离放疗能够较准确地给出靶区和危及器官剂量。因而本课题将研究CT引导下三维腔内后装放疗联合外照射在食管癌中的应用及疗效分期，为食管癌的治疗提供可靠的科学依据，具有一定临床意义和推广可行性。本研究分析三维腔内后装联合外照射在食管癌中的应用及疗效，现报道如下。

1 资料与方法

1.1 一般资料

选择我院2018年1—12月食管癌患者70例，采用随机数字表法分为研究组与对照组，每组各35例，对照组男25例，女10例，年龄61～76岁，平均（65.21±2.68）岁。其中胸段食管癌20例、下段食管癌10例、中段食管癌为5例。观察组男24例，女11例，年龄61～78岁，平均（65.78±2.89）岁。其中胸段食管癌20例，下段食管癌9例，中段食管癌为6例。两组一般资料比较，差异无统计学意义（P>0.05），具有可比性。本研究经本院医学伦理委员会批准，患者或家属知情同意。纳……