80岁以上老年人食管癌适形调强放疗与常规放疗疗效比较

发布时间：2018-05-25 23:25

  本文选题：老年患者 + 食管肿瘤　； 参考：《中华全科医学》2016年09期

【摘要】：目的探讨适形调强放疗与常规放疗治疗80岁以上老年人食管癌的疗效及毒副反应。方法回顾性分析2009年11月—2012年10月收住肿瘤放疗科并完成根治性放射治疗的80岁以上食管癌患者共41例。其中适形调强放疗18例,常规放疗23例,总处方剂量DT 48~69 Gy,24~34次完成。统计2组的近期、远期疗效、症状缓解率及毒副反应。采用Kaplan-Meier法和Log-rank法分析比较生存率。结果适形调强组、常规放疗组近期有效率分别为88.9%、60.9%(χ~2=4.308,P=0.044);中位生存期分别为12个月和9个月,其1年、3年生存率分别为44.4%(8/18)、21.7%(5/23)和16.7%(3/18)、4.3%(1/23)(χ~2=5.919,P=0.015)。适形调强组症状缓解率83.3%(15/18),常规放疗组症状缓解率82.6%(19/23),2组比较差异无统计学意义(χ~2=0.004,P=0.951)。在毒副反应方面,主要不良反应为Ⅰ~Ⅱ度放射性食管炎、放射性肺炎、骨髓抑制及食欲减退,2组均未出现3级以上放疗反应。结论对于80岁以上食管癌患者,放射治疗是一种安全有效的治疗手段,采用适形调强放射治疗可以进一步提高疗效。
[Abstract]:Objective to evaluate the efficacy and side effects of conformal intensity modulated radiotherapy (IMRT) and conventional radiotherapy in the treatment of esophageal cancer over 80 years old. Methods from November 2009 to October 2012, 41 patients with esophageal cancer over 80 years old who received radiotherapy for cancer and completed radical radiotherapy were retrospectively analyzed. There were 18 cases of conformal intensity modulated radiotherapy and 23 cases of conventional radiotherapy. The total prescription dose of DT4869 Gyrone 2434 times was completed. The short-term, long-term effects, remission rate and side effects of the two groups were analyzed. The survival rate was analyzed by Kaplan-Meier method and Log-rank method. Results in the conformal intensity control group, the short-term effective rates of conventional radiotherapy group were 88.9 and 60.9 (蠂 ~ (24) 308p ~ (0.044), the median survival time was 12 months and 9 months, respectively. The 1-year and 3-year survival rates were 44.44 / 18 / 21. 7 / 23 and 16. 733 / 18 / 4.323 (蠂 ~ (2 / 2) 5.919 / P 0.015), respectively. There was no significant difference in the remission rate of symptoms between the conformal intensity control group (83.3 / 18) and the conventional radiotherapy group (82.6 / 23 / 23) (蠂 ~ (2 / 2) 0.004 / P ~ (0.951). The main adverse reactions were radiation esophagitis, radiation pneumonia, bone marrow suppression and anorexia. There was no radiation reaction above grade 3 in group 鈪，

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