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目的观察颈部彩超联合调强放射治疗食管癌的治疗效果。方法选取食管癌患者86例,随机分为A组(颈部彩超组)43例和B组(对照组)43例。A组放疗前行颈部彩超检查,发现有淋巴结转移的作为累及野照射,二组均行调强放疗。操作方法:95%的PTV(计划靶区)所受剂量作为处方剂量,采用5野的调强计划,处方剂量为62~66Gy/31~33次,5次/周,随访时间36~60个月,观察局控率、颈转率、远转率、生存率。结果二组对照研究可以看出,A组在1、2、3年颈转率明显降低,P<0.05,差异有统计学意义。在远转率和生存率方面也有所下降,但差异无统计学意义。放疗不良反应主要以1~2级为主。结论颈部彩超在食管癌的调强放疗中可作为颈部照射野的依据,能降低食管癌的颈部转移率,毒副反应可耐受。
Objective To observe the therapeutic effect of cervical ultrasonography combined with intensity-modulated radiation on esophageal cancer. Methods Totally 86 esophageal cancer patients were randomly divided into group A (43 cases) and group B (43 cases). Group A before radiotherapy cervical ultrasonography and found that lymph node metastasis as involved in field irradiation, two groups were performed intensity modulated radiotherapy. Method of operation: 95% of the dose of PTV (planned target area) as a prescription dose, with a 5-field intensity-modulated plan, the prescribed dose of 62 to 66 Gy / 31 to 33 times, 5 times / week, followed up for 36 to 60 Month, observation bureau control rate, cervical rate, distant rate, survival rate. Results The two groups of control studies can be seen, A group in 1, 2, 3 years significantly reduced cervical rate, P <0.05, the difference was statistically significant. There was also a decrease in the rate of distant metastasis and the survival rate, but the difference was not statistically significant. Adverse reactions to radiotherapy mainly to 1 to 2 dominated. Conclusions Cervical ultrasonography can be used as the basis of neck irradiation in IMRT of esophageal cancer, which can reduce the cervical metastasis rate of esophageal cancer and can tolerate toxic and side effects.