食管癌根治性放疗选择性淋巴引流区预防照射与累及野照射的疗效
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摘要
目的探讨根治性放疗食管癌患者选择性淋巴引流区预防照射(ENI)与累及野照射(IFI)的疗效。方法选取2011年3月至2015年3月间福建省龙岩市第二医院收治的行根治性放疗的96例食管癌患者为观察对象进行回顾性分析。其中,采用选择性淋巴引流区预防照射的48例患者纳入ENI组,采用累及野照射的48例患者纳入IFI组。比较分析两组患者放疗后临床总有效率、治疗后3年内局部控制率、生存率和放疗后不良反应发生率。结果 ENI组患者放疗后临床总有效率与IFI组患者比较,差异无统计学意义(P> 0. 05)。ENI组患者治疗3年内局部控制率和生存率与IFI组患者比较,差异无统计学意义(P> 0. 05)。ENI组患者术后并发症发生率明显高于IFI组患者,差异有统计学意义(P <0. 05)。结论给予食管癌患者根治性放疗时,累及野照射的临床总有效率、生存率和局部控制率方面与选择性淋巴引流区预防照射疗效相当,但累及野照射可降低放疗后患者的不良反应发生率,具有较高的临床价值。
Objective To explore the efficacy of elective node irradiation( ENI) and involved-field irradiation( IFI) in radical radiotherapy for esophageal cancer. Methods A total of 96 patients with esophageal cancer who received radical radiotherapy at The Second Hospital of Longyan from March 2011 to March 2015 were randomly selected for retrospective analysis. The patients were divided into ENI group and IFI group with 48 patients in each group. The clinical overall efficacy rate,3-year local control rate,survival rate and adverse reactions after radiotherapy were compared and analyzed between the two groups.Results The overall efficacy rate in the ENI was equivalent to that in the IFI group( P > 0. 05). The 3-year local control rate and survival rate in the ENI were comparable with that in the IFI group( all P >0. 05). The postoperative adverse reactions in ENI group was higher than in the IFI group( P < 0. 05).Conclusion When radiotherapy is given to patients with esophageal cancer,the clinical overall efficacy rate,survival rate and local control rate for the elective node irradiation were comparable with involved-field irradiation. However,the incidence of adverse reactions after radiotherapy can be effectively reduced if involved-field irradiation is performed. It has high clinical value.
Objective To explore the efficacy of elective node irradiation( ENI) and involved-field irradiation( IFI) in radical radiotherapy for esophageal cancer. Methods A total of 96 patients with esophageal cancer who received radical radiotherapy at The Second Hospital of Longyan from March 2011 to March 2015 were randomly selected for retrospective analysis. The patients were divided into ENI group and IFI group with 48 patients in each group. The clinical overall efficacy rate,3-year local control rate,survival rate and adverse reactions after radiotherapy were compared and analyzed between the two groups.Results The overall efficacy rate in the ENI was equivalent to that in the IFI group( P > 0. 05). The 3-year local control rate and survival rate in the ENI were comparable with that in the IFI group( all P >0. 05). The postoperative adverse reactions in ENI group was higher than in the IFI group( P < 0. 05).Conclusion When radiotherapy is given to patients with esophageal cancer,the clinical overall efficacy rate,survival rate and local control rate for the elective node irradiation were comparable with involved-field irradiation. However,the incidence of adverse reactions after radiotherapy can be effectively reduced if involved-field irradiation is performed. It has high clinical value.
引文
[1]祝淑钗,董辉,沈文斌,等.食管癌调强放疗淋巴引流区预防照射的同期对照研究[J].中华放射医学与防护杂志,2014,34:758-762.
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[4]陆艳荣,瓦热斯江·衣不拉音,巴尔夏古丽·扎比胡拉,等.食管癌根治性放疗选择性淋巴引流区预防照射与累及野照射的局部控制率、生存率比较分析[J].中国医刊,2018,53:573-576.
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[6]祝淑钗,许金蕊,刘志坤,等.三维技术放疗食管癌不同临床靶区的初步研究[J].中华放射肿瘤学杂志,2014,23:127-130.
[7]李启英,黄露迷,冀晓辉,等.紫杉醇脂质体联合奈达铂治疗晚期食管癌的疗效观察[J].中国肿瘤临床与康复,2015,22:1339-1341.
[8]于波,汪建林,刘惠兰,等. 373例食管癌患者三维技术放疗预后分析[J].中华放射医学与防护杂志,2018,38:174-179.
[9]王能超,何志杰,张涛,等.食管癌同步加量调强放疗与常规调强放疗临床对照研究[J].肿瘤基础与临床,2016,29:318-321.
[10]曹焱,张超.血清癌胚抗原和细胞角蛋白19片段对食管癌患者放疗效果及生存状况的评估[J].中国肿瘤临床与康复,2015,22:1284-1287.
[2]董辉,祝淑钗,苏景伟,等.食管癌根治性放疗中ENI与IFI失败模式研究[J].中华放射肿瘤学杂志,2014,23:479-483.
[3]何慧娟,胡伟.放疗对高龄食管癌患者的疗效及预后影响因素研究[J].中国全科医学,2018,21:430-434.
[4]陆艳荣,瓦热斯江·衣不拉音,巴尔夏古丽·扎比胡拉,等.食管癌根治性放疗选择性淋巴引流区预防照射与累及野照射的局部控制率、生存率比较分析[J].中国医刊,2018,53:573-576.
[5]姬凯,赵路军,杨成文,等.胸段食管鳞癌累及野放疗时淋巴引流区剂量分析[J].中华放射肿瘤学杂志,2013,22:30-34.
[6]祝淑钗,许金蕊,刘志坤,等.三维技术放疗食管癌不同临床靶区的初步研究[J].中华放射肿瘤学杂志,2014,23:127-130.
[7]李启英,黄露迷,冀晓辉,等.紫杉醇脂质体联合奈达铂治疗晚期食管癌的疗效观察[J].中国肿瘤临床与康复,2015,22:1339-1341.
[8]于波,汪建林,刘惠兰,等. 373例食管癌患者三维技术放疗预后分析[J].中华放射医学与防护杂志,2018,38:174-179.
[9]王能超,何志杰,张涛,等.食管癌同步加量调强放疗与常规调强放疗临床对照研究[J].肿瘤基础与临床,2016,29:318-321.
[10]曹焱,张超.血清癌胚抗原和细胞角蛋白19片段对食管癌患者放疗效果及生存状况的评估[J].中国肿瘤临床与康复,2015,22:1284-1287.