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目的:评估三维适形放射治疗(3DCRT)食管癌的疗效、副反应及预后因素。方法:采用三维适形放射治疗经组织学证实的食管癌患者50例,2.0Gy/次,5次/周,总剂量60Gy-74Gy,其中单独放疗24例,序贯放化疗26例,分析患者的1、2、3、4年局控率、生存率和预后因素。结果:全组患者治疗后总有效率(CR+PR)为90%。1、2、3、4年局控率分别为76%、66%、62%、54%。1、2、3、4年生存率分别为76%、56%、40%、14%。放射性食管炎1级19例(38%),2级6例(12%),3级3例(6%)。白细胞减少1级11例(22%),2级8例(16%),3级2例(4%),4级1例(2%)。单因素分析显示临床分期、疗前进食状况、病变长度对生存率有影响。多因素分析显示临床分期和疗前进食状况是影响生存的独立预后因素。结论:食管癌采用3DCRT可得到较好的局控率和生存率以及较低的副反应发生率,临床分期和疗前进食状况是预后的影响因素。
Objective: To evaluate the efficacy, side effects and prognostic factors of three dimensional conformal radiotherapy (3DCRT) esophageal cancer. Methods: Fifty patients with esophageal cancer confirmed by histology were treated with three-dimensional conformal radiation. The total dose was 60Gy-74Gy at 2.0Gy / time and 5 times / week, including 24 cases of radiotherapy alone and 26 cases of sequential radiotherapy and chemotherapy. 1, 2, 3, 4 years of local control rate, survival rate and prognostic factors. Results: The total effective rate (CR + PR) of all patients after treatment was 90%. The rates of 1, 2, 3 and 4 years were 76%, 66%, 62% and 54% respectively. The 1, 2, 3, 4-year survival rates were 76%, 56%, 40%, 14% respectively. Radioactive esophagitis grade 1 in 19 cases (38%), grade 2 in 6 cases (12%), grade 3 in 3 cases (6%). Grade 1 leucopenia in 11 cases (22%), grade 2 in 8 cases (16%), grade 3 in 2 cases (4%) and grade 4 in 1 case (2%). Univariate analysis showed that the clinical stage, pre-treatment eating status, the length of the lesion has an impact on the survival rate. Multivariate analysis showed that clinical staging and pre-treatment eating status were independent predictors of survival. Conclusion: 3DCRT can be used to get a better control rate and survival rate of esophageal cancer and a lower incidence of side effects. The clinical stage and pre-treatment eating status are the prognostic factors.