| 白文文,付丽媛,李静,张若辉,甄婵军,张瑞,王硕烁,刘明,乔学英.食管癌同期推量调强放疗和后程缩野加量调强放疗的临床对比研究[J].中华放射医学与防护杂志,2018,38(4):258-264 |
| 食管癌同期推量调强放疗和后程缩野加量调强放疗的临床对比研究 |
| Comparison of simultaneous integrated boost and late course boost intensity-modulated radiation therapy in the treatment of esophageal carcinoma |
| 投稿时间：2017-07-17 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.04.004 |
| 中文关键词: 食管肿瘤 放射治疗 同期推量调强放疗 后程缩野加量调强放疗 疗效 |
| 英文关键词:Esophageal neoplasms Radiotherapy Simultaneous integrated boost intensity-modulated radiation therapy/SIB-IMRT Late course boost to primary tumor with intensity-modulated radiation therapy/LCB-IMRT Efficacy |
| 基金项目:河北省卫生厅重点科技研究计划项目（20170702） |
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| 中文摘要: |
| 目的 分析和比较食管癌同期推量调强放疗（SIB-IMRT）和后程缩野加量调强放疗（LCB-IMRT）的疗效。方法 回顾性分析2009年1月至2015年12月本院放疗五科收治的128例接受SIB-IMRT或LCB-IMRT技术的食管鳞癌患者的临床资料，采用倾向评分匹配法（propensity score matching，PSM）平衡SIB-IMRT组及LCB-IMRT组基本资料不均衡的变量，观察和比较两组的局部控制、生存、不良反应及首次失败方式。结果 匹配后两组共111例患者，全组1、3、5年局部控制率分别为83.6%、70.8%、66.0%，1、3、5年生存率分别为81.7%、46.3%、38.2%。SIB-IMRT组与LCB-IMRT组的1、3、5年局部控制率分别为81.6%、72.3%、68.5%和88.0%、67.6%、60.8%（P>0.05）；1、3、5年生存率分别为81.3%、51.7%、45.8%和82.4%、36.7%、26.7%（P>0.05）。两组≥ 3级的不良反应差异无统计学意义（P > 0.05）。全组共40例患者治疗失败，总失败率为36.0%，其中SIB-IMRT组失败率为33.8%（26/77），LCB-IMRT组为41.2%（14/34），两组比较差异无统计学意义（P>0.05）。全组局部失败占总治疗失败的65.0%。结论 食管癌SIB-IMRT和LCB-IMRT的不良反应相似，耐受性可；两组总的局部控制和生存无明显差异，但SIB-IMRT组有优于LCB-IMRT组的趋势，考虑SIB-IMRT技术更简便易行，中晚期食管癌放疗时采用SIB-IMRT技术可能是更好的选择。 |
| 英文摘要: |
| Objective To analyze and compare the outcomes of esophageal carcinoma treated with simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) and late course boost intensity-modulated radiation therapy (LCB-IMRT). Methods We retrospectively analyzed 128 patients with esophageal squamous cell carcinoma who were treated with SIB-IMRT or LCB-IMRT at the fifth department of radiation oncology in our hospital,from January 2009 to August 2015. Propensity score matching analysis was used to balance the variables differences in the two groups. Survival, failure patterns and toxicities were observed and compared between the two groups.Results one hundred and eleven patients were finally included after propensity scores matching. The l-, 3-and 5-year local control rates and survival rates were 83.6% vs. 81.7%, 70.8% vs. 46.3% and 66.0% vs. 38.2% in the whole group, respectively. The 1-, 3-and 5-year local control rates of SIB-IMRT and LCB-IMRT group were 81.6% vs. 88.0%, 72.3% vs. 67.6% and 68.5% vs. 60.8%, respectively (P > 0.05). The 1-, 3-and 5-year survival rates of SIB-IMRT and LCB-IMRT group were 81.3% vs. 82.4%, 51.7% vs. 36.7% and 45.8% vs. 26.7%, respectively (P > 0.05). There was no statistical difference between the two group in ≥ grade 3 toxicities (P > 0.05). There were 40 (36.0%) patients result in treatment failure in all. The treatment failure rates in SIB-IMRT and LCB-IMRT group were 33.8% (26/77) vs. 41.2%(14/34), respectively (P > 0.05). The local failure accounted for 65.0% (26/40) of all treatment-related failures. Conclusions The toxicities of esophageal squamous cell carcinoma treated with SIB-IMRT and LCB-IMRT have no significant differences and were well tolerated. There were no significant differences in local control rates and survival rates between the two groups. However, SIB-IMRT had better trend than LCB-IMRT. Given SIB-IMRT's convenient manipulation, it could be a better choice in the treatment of advanced esophageal carcinoma. |
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