中华肿描防治杂志20】0年12月第17卷第24期CHINJCANCERPREVTREAT.Decemb"2010.VoL17No.24(临床应用研究)中晚期食管癌三维适形放疗联合同期化疗的临床观察王澜，韩春，李晓宁，高超，呂冬婕河北医科大学第四医院放疗科，河北石家庄050011Three-dimensionalconformalradiotherapycombinedwithconcurrentchemotherapyforlocallyadvaneedesophagealcarcinomaWANGLan<HANChuntLIXiao-nin^*GAOChao•LUI)on(^jieDepartmentofRadiationOncology»FourthHospitalofHebeiMedicalUniversity・Shijiazhuang050011,P.R.China[ABSTRACT]OBJECTIVE：Toobservetheacutesideeffectsandclinicalresultsofthree-dimensionalconformalradiotherapy(3DCRT)combinedwithchemotherapyforesophagealcarcinoma.METHODS：Totally62patientswithesophagealcarcinomareceived3DCRTcombinedwithconcurrentchemotherapyofLFP.Thesideeffectsandclinicalresultswereobserved.RESULTS：1)Ofallthepatients^6]completedradiotherapy<29patientscompleted3ormorethan3cyclesofchemotherapy•18completed2cyclesand15completedonly1cycle.2)Theacutetoxicreac・tionsweremarrowdepressionandgastrointestinaltractreactionmainly•49(79.03%)patientsdevelopedthesideeffectsofnausea>vomitingandconstipation•andtheincidenceofleucopeniawas80.65%(50/62).Fiftypatients(80.65%)developedacuteradiationesophagitiswith88.00%(44/50)ofgrade1andgrade2.and24patients(38.71%)developedacuteradiationpneumonitiswith54.17%(13/24)ofgrade1.3)The1-t2->3-yearlocalcontrolrateswere89.97%.70.66%and70.66%•respectively.Thel->2-13-yearoverallsurvivalrateswere8&33%.55.78%and52.68%.respectivelytandthemediansurvivaltimewas28months.ForthepatientswhosemaximumtransdiameterofGTVwaslessandmorethan4cm,the1->3-yearsurvivalrateswere96・88%・74.27%・68.08%and78.57%«34.83%and34.83%.respectively(x?=7.48>P=0.0062).CONCLUSIONS：3DCRTcom-binedwithconcurrentchemotherapyofI.FPhasitsfeasibilityandthemajorityofpatientscouldtoleratethetreatment.Thispatternoftreatmentcouldmakewelllocalcontrolrateandsurvivalrate*andthecliniceffecthasthepotentialofimprovementsbutthecontrolofmetastasishasnoimprovement.ChinJCancerPrevTreat«2010«17(24)：20532056【关键词】食管肿瘤/放射疗法：放射疗法，三维适形；食管肿瘤/药物疗法：生存率KEYWORDS]esophagealneoplasms/radiotherapy；radiotherapy»threedimensionalconformal；esophagealneoplasms/drugtherapy；survivalrate【基金项目】河北省高校强勞特色学科资助课題(200552)【第一作者简介】王澜•女，河北沧州人，硕士•主治医师•主要从事敖射肿瘤学的研究工作.&mail：wlan2OO6@sina.com【通讯作者简介】韩春，男，河北行唐人，主任医师，教授•硕士生导师•主要从爭放射肿瘤学的临床研究工作.E-mail:har)chun2006@126.com【摘要】目的：观察三维适形放疗联合同期化疗治疗中晚期食管癌的丢副反应与临床疗效。方法：62例符合入纽条件的中晚期食管癌患者接受三维适形放疗及同期化疗。放疗处方刑童60Gy/30次•化疗选择LFP方案•观察总者的治疗完成情况、放化疗奉副反应及临床疗效。结果：1)61例患者如期完成放疗，化疗完成$3个周期者29例.完成2个周期者18例•仅完成1个周期者15例。2)治疗的急性毒性反应主要为骨髓抑制和胃肠道反应，其中胃肠道反应总发生率为79.03%(49/62)・白细胞减少总发生率为80.65%(50/62),急性放射性食管炎总发生率为80・65%(50/62几其中以1级和2级占8&00%(44/50)o急性放射性肺炎的总发生率为3&71%(24/62).其中1级占54.17%(13/24)。3)全组患者1、2和3年局控率分别为89.97%、70・66%和70・66%,1、2和3年生存率分别为8&33%、55・78%和52.68%•中位生存期28个月.GTV最尢横径W4cm组与>4cm组1.2和3年生存率分别为96.88%.74.27%、68.08%和78.57%、34・83%、34・83%.£=7.48,P=0.0062.结论：三址适形放疗联合I.FP方案同期治疗...