摘要
目的 探讨三维适形放射治疗(3D-CRT)和调强放射治疗(IMRT)在食管癌术后患者辅助治疗中的应用效果。方法 回顾性分析2020年3月至2022年2月于福建医科大学附属漳州市医院行手术治疗的70例食管癌患者的临床资料,其中35例术后采用3D-CRT(3D-CRT组),另外35例术后采用IMRT(IMRT组),参考剂量体积直方图(DVH)比较两组的靶区剂量学参数[计划靶区(PTV)百分比(V100%)、靶区适形性指数(CI)、剂量均匀性指数(HI)]及心脏、肺、脊髓、气管等危及器官参数,并比较两组的不良反应(心脏损伤、放射性肺炎、胃肠道反应)发生情况和1年内无进展生存率(PFS)。结果 3D-CRT组的V100%低于IMRT组,CI、HI高于IMRT组,差异均有统计学意义(P<0.05);3D-CRT组的心脏Dmean、肺Dmean均高于IMRT组,差异有统计学意义(P<0.05);两组脊髓、气管的受照射剂量比较,差异无统计学意义(P>0.05);3D-CRT组的不良反应总发生率高于IMRT组,差异有统计学意义(P<0.05);两组1年内PFS比较,差异无统计学意义(P>0.05)。结论 相较于3D-CRT,IMRT在食管癌患者术后辅助治疗中的安全性较高,可进一步提高靶区覆盖率及适形性,合理控制不均匀放射剂量,减少对心脏、肺等危及器官的放射剂量。
Objective To investigate the effect of three-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT) in the adjuvant therapy of postoperative patients with esophageal cancer.Methods Clinical data of 70 patients with esophageal cancer who received surgical treatment in Zhangzhou Hospital Affiliated to Fujian Medical University from March 2020 to February 2022 were retrospectively analyzed.Among them,35 patients received postoperative 3D-CRT (3D-CRT group) and 35 patients received postoperative IMRT (IMRT group).The reference dose volume histogram (DVH) compared the target dosimetry parameters[planned target (PTV) percentage (V100%),target conformance index (CI),dose uniformity index (HI)]and the parameters of heart,lung,spinal cord,trachea and other organs at risk between the two groups.The incidence of adverse reactions (cardiac injury,radiation pneumonia,gastrointestinal reactions) and 1-year progression-free survival(PFS) were compared between the two groups.Results The V100%of the 3D-CRT group was lower than that of the IMRT group,while CI and HI were higher than that of the IMRT group,and the differences were statistically significant (P<0.05).The heart Dmeanand lung Dmeanof 3D-CRT group were higher than those of IMRT group,and the difference was statistically significant(P<0.05).There was no significant difference in radiation dose of spinal cord and trachea between the two groups (P>0.05).The total incidence of adverse reactions in 3D-CRT group was higher than that in IMRT group,and the difference was statistically significant (P<0.05).There was no significant difference in PFS between the two groups within 1 year (P>0.05).Conclusion Compared with 3D-CRT,IMRT has higher safety in postoperative adjuvant therapy for patients with esophageal cancer,which can further improve the target coverage and confitness,reasonably control the uneven radiation dose,and reduce the radiation dose to the heart,lungs and other organs at risk.
作者
余育贤
张龙泉
朱明阳
李晓林
Yu Yuxian;Zhang Longquan;Zhu Mingyang;Li Xiaolin(Zhangzhou Hospital Affiliated to Fujian Medical University,Zhangzhou Fujian 363000,China)
出处
《医疗装备》
2023年第4期90-93,共4页
Medical Equipment
关键词
调强放射治疗
三维适形放射治疗
食管癌
危及器官
Conformal intensity modulated radiotherapy
Three-dimensional conformal radiotherapy
Esophageal cancer
Organs at risk
