| 祝淑钗,尤鑫,李曙光,许金蕊,赵彦,宋春洋.食管癌三维适形调强放疗不同靶区照射局部失败的剂量学比较[J].中华放射医学与防护杂志,2015,35(11):830-834 |
| 食管癌三维适形调强放疗不同靶区照射局部失败的剂量学比较 |
| Comparison of dose-volume parameters for local failure in esophageal cancers treated by 3D-CRT or IMRT with different target regions |
| 投稿时间：2015-02-25 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.11.007 |
| 中文关键词: 食管癌 调强放疗 靶区 局部失败 |
| 英文关键词:Esophageal carcinoma Intensity radiotherapy Target volume Localized failure |
| 基金项目:河北省医学适用技术跟踪项目(GL200848) |
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| 中文摘要: |
| 目的 探讨食管癌不同靶区范围根治性放疗后食管病变局部复发与受照剂量的关系。方法 回顾性分析244例行根治性三维适形调强放疗的食管癌患者资料,比较有无食管病变局部复发患者的靶区体积的剂量、体积参数,并分层比较不同影响因素时两组患者靶区体积的剂量、体积参数的差异。结果 食管病变局部复发组与无复发组各靶体积的剂量、体积参数比较,差异无统计学意义(P>0.05)。行淋巴引流区预防野(ENI)照射时,复发组与无复发组的剂量、体积参数比较,差异无统计学意义(P>0.05);而行累及野(IFI)照射时,复发组的GTV-V60、CTV-V60、PTV-V60均明显小于无复发组(t=-2.08、-2.19、-2.08, P<0.05)。行ENI照射时的GTV、CTV、PTV所受剂量和PTV的剂量体积均明显大于IFI照射(t=1.97~3.12, P<0.05)。当食管病变局部GTV<30 cm3和未行同期化疗时,复发者的CTV-D98%、CTV-D95%所接受的照射剂量均明显低于无复发者(t=-2.24~-2.07, P<0.05)。结论 食管癌根治性放疗,淋巴引流区预防照射可使治疗靶区体积获得更大的处方剂量和更高的处方剂量体积,能够降低食管病变局部复发。尤其当食管病变偏小和未同期化疗时,从淋巴引流区预防照射中获益更大。 |
| 英文摘要: |
| Objective To compare dose-volume parameters for local failure in esophageal cancers treated by there-dimensional conformal radiotherapy(3D-CRT) or intensity modulated radiotherapy(IMRT) with different target regions.Methods A total of 244 patients with esophageal cancer(including 127 patients with local recurrence and 117 without recurrence) underwent radical 3D-CRT and IMRT were enrolled in this study. Data including dose-volume parameters and clinical features were analyzed retrospectively. Results No statistically significant differences were found in the dose-volume parameters of different planning target regions between groups with local tumor recurrence and without recurrence(P>0.05). In the elective nodal irradiation(ENI) group, neither the recurrence and the non-recurrence groups showed statistical differences in the dose-volume parameters(P>0.05). While for the involved-field iradiation(IFI) group, the GTV-V60, CTV-V60, PTV-V60 of local recurrent group were significantly lower than those in the non-recurrent group(t=-2.08,-2.19,-2.08, P<0.05). In the ENI group, radiated doses of GTV, CTV and PTV as well as dose-volume of PTV were significantly higher than the IFI group(t=1.97-3.12, P<0.05). For patients with a esophageal GTV less than 30 cm3 but without concurrent chemotherapy, radiated dose of CTV-D98%, CTV-D95% in the recurrent group were significantly lower than in non-recurrent group(t=-2.24--2.07, P<0.05). Conclusions Elective nodal prophylactic radiation of esophageal carcinoma could provide greater volume and doses of GTV, CTV and PTV to prescribed target regions, which may decrease local recurrence. Greater efficiency can be obtained when the primary lesion of the esophageal cancer is smaller or at an early stage, and concurrent chemotherapy is not given. |
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