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目的探讨大分割调强适形放疗(IMRT)同步化疗治疗食管气管沟淋巴结(TGLN)转移的临床疗效及不良反应。方法选取2013年1月至2014年6月间盐城市第三人民医院收治的53例食管癌术后食管气管沟淋巴结转移患者,按治疗方案的不同将患者分为综合治疗组25例和单纯放疗组28例。单纯放疗组采用IMRT治疗,综合治疗组采用IMRT联合紫杉醇化疗治疗,比较两组患者的临床疗效和不良反应发生情况。结果两组患者总有效率和1年生存率比较,差异无统计学意义(P>0.05)。综合治疗组患者2年生存率高于单纯放疗组,差异有统计学意义(P<0.05)。肿瘤直径≤2cm患者的有效率、1年和2年生存率均优于直径>2cm的患者,差异均有统计学意义(均P<0.05)。两组患者的放射性食管炎和气管炎等不良反应发生情况比较,差异无统计学意义(P>0.05)。结论大分割IMRT同步化疗治疗食管气管沟淋巴结转移疗效较好,特别对肿瘤直径≤2cm者尤为显著,可缩短治疗时间,并发症较少,安全性较高。
Objective To investigate the clinical effects and adverse reactions of large-split intensity modulated radiation therapy (IMRT) with concurrent chemotherapy in the treatment of esophageal tracheal-gullet lymph node metastasis (TGLN). Methods From January 2013 to June 2014, Yancheng Third People’s Hospital admitted 53 patients with esophagectomy postoperative esophageal tracheal lymph node metastasis patients according to the different treatment options will be divided into comprehensive treatment group of 25 patients and radiotherapy alone Group of 28 cases. Simple radiotherapy group with IMRT treatment, comprehensive treatment group using IMRT combined with paclitaxel chemotherapy, the clinical efficacy and adverse reactions in both groups were compared. Results There was no significant difference between the two groups in total effective rate and 1-year survival rate (P> 0.05). The 2-year survival rate of the comprehensive treatment group was higher than that of the radiotherapy alone group, the difference was statistically significant (P <0.05). The effective rate of patients with tumor diameter less than or equal to 2 cm and the 1-year and 2-year survival rates were superior to those with diameter> 2 cm (all P <0.05). Two groups of patients with radiation esophagitis and tracheitis and other adverse reactions, the difference was not statistically significant (P> 0.05). Conclusions Large segmental IMRT is more effective in the treatment of esophageal tracheal glottic lymph node metastasis, especially for those with tumor diameter less than or equal to 2cm, which can shorten the treatment time with fewer complications and higher safety.