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颈及胸上段食管癌同时整和加量调强放射治疗分析[J]. 肿瘤防治研究, 2010, 37(05): 575-577. DOI: 10.3971/j.issn.1000-8578.2010.05.023
引用本文: 颈及胸上段食管癌同时整和加量调强放射治疗分析[J]. 肿瘤防治研究, 2010, 37(05): 575-577. DOI: 10.3971/j.issn.1000-8578.2010.05.023
SIB-IMRT for Neck and Upper Thoracic Esophageal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2010, 37(05): 575-577. DOI: 10.3971/j.issn.1000-8578.2010.05.023
Citation: SIB-IMRT for Neck and Upper Thoracic Esophageal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2010, 37(05): 575-577. DOI: 10.3971/j.issn.1000-8578.2010.05.023

颈及胸上段食管癌同时整和加量调强放射治疗分析

SIB-IMRT for Neck and Upper Thoracic Esophageal Carcinoma

  • 摘要: 目的 对颈及胸上段食管癌实施同时整和加量调强放射治疗(simultaneous integrated boost intensity-modulated radimion therapy,SIB-IMRT)计划,并分析急性放射反应和近期疗效。 方法 对27例颈及胸上段食管癌的原发灶和预防照射区进行SIB-IMRT计划设计。定义2个靶区:PTV1 为需要加量照射的原发灶靶区,给予66Gy(2.2Gy×30次);PIV2为预防照射区,给予54Gy(1.8Gy ×30次)的剂量,设计等角度5野调强计划。 结果 所有患者均在6周内完成治疗计划,治疗中仅1例发生3级放射性气管炎,但未有因放疗反应而中断治疗患者。近期疗效:食管病灶CR者达85.2%(23/27),PR达14.8%,总有效率达100%,淋巴结病灶CR者达70.6%(12/17),PR者达29.4%(5/17)。 结论 5野调强照射野即可使上段食管癌的同时整和加量(simultaneous integrated boost,SIB)治疗获得理想的剂量分布,尤其对有淋巴结转移患者克服了既往治疗的不足,近期治疗效果满意,急性放射反应可耐受,远期治疗效果及组织损伤有待长期随访观察。

     

    Abstract: Objective To implement simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) plans for curingneck and upper thoracic esophageal carcinoma, and investigate the acute toxicity and early response. Methods SIB-IMRT plans were designed for 27 patients with neck and upper thoracic carcinoma. Two target volumes were predefined: PTV1, the target volume of primary lesion, which was given66Gy(2.2×30 fractions); PTV2, the target volumes of electively treated lesion, which was given54Gy(1.8×30 fractions).The plans were with coplanar beams. Results All the patients completed the treatment within 6 weeks. Only one with grade 3 acute bronchitis was observed. The immediate responses were CR 85.2% (23/27), PR 14.8%(4/27), overall response was 100% in esophageal lesion and CR 70.6% (12/17), PR 29.4%(5/17) in lymph node lesion. Conclusion Five coplanar beams IMRT can produce desirable dose distribution for SIB treatment of neck and upper thoracic esophageal carcinoma, especially the one with positive lymph node. Immediate response is satisfying and acute toxicity is not severe. But long-term effect and late toxicity need to be further studied.

     

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