实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (10): 1010-1014.doi: 10.3969/j.issn.1003-9198.2022.10.009

• 临床研究 • 上一篇    下一篇

调强放疗的不同剂量分割模式对老年食管鳞癌的临床疗效观察

李小龙, 刘秋芳, 李量, 王天昶, 王锋刚, 吴磊, 戴震, 陆婉玲   

  1. 710061 陕西省西安市,陕西省肿瘤医院放疗一科(李小龙,刘秋芳,李量,王天昶,王锋刚,吴磊,戴震);
    710054 陕西省西安市,中国人民解放军空军第986医院肿瘤科(陆婉玲)
  • 收稿日期:2021-11-27 出版日期:2022-10-20 发布日期:2022-10-21
  • 通讯作者: 陆婉玲,Email: lwldst@sina.com
  • 基金资助:
    陕西省社会发展科技攻关项目(2015SF060)

Clinical observation of different dose-fractionations of intensity-modulated radiotherapy for elderly patients with esophageal squamous cell carcinomas

LI Xiao-long, LIU Qiu-fang, LI Liang, WANG Tian-chang, WANG Feng-gang, WU Lei, DAI Zhen, LU Wan-lin   

  1. LI Xiao-long, LIU Qiu-fang, LI Liang, WANG Tian-chang, WANG Feng-gang, WU Lei, DAI Zhen. Department of Radiotherapy, Shaanxi Cancer Hospital, Xi'an 710061, China;
    LU Wan-lin. Department of Oncology, PLA Air Force 986 Hospital, Xi'an 710054, China
  • Received:2021-11-27 Online:2022-10-20 Published:2022-10-21

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摘要： 目的 比较调强放疗的不同分割模式对老年中晚期食管癌的临床疗效,探索最佳剂量分割模式。 方法 收集2010年10月至2015年2月在我院接受放疗的老年食管鳞癌病人102例,按照分割模式分为3组,A组:单次放疗剂量为2.0 Gy,共25~30次,总剂量为50~60 Gy,生物等效剂量(BED)60~72 Gy;B组:单次放疗剂量为2.2 Gy,共23~27次,总剂量为50.6~59.4 Gy,BED:61.7~72.5 Gy;C组:单次放疗剂量为2.5 Gy,共19~23次,总剂量为47.5~57.5 Gy,BED:59.4~71.9 Gy。比较3组间调强放疗的不良反应、局部控制率和生存率。 结果 A、B、C 3组总有效率分别为82.8%(24/29)、91.7%(44/48)、96.0%(24/25),差异无统计学意义(P>0.05)。A、B、C 3组1~3年局部控制率差异无统计学意义(P>0.05),1~2年的生存率差异也无统计学意义(P>0.05),3年生存率差异有统计意义(17.2% vs 31.3% vs 16.0%,P=0.049)。 结论 调强放疗中低分割(2.2 Gy)放疗模式是老年中晚期食管鳞癌病人的放疗可选方案,但是最佳模式尚需进一步临床验证。

关键词: 食管鳞癌, 老年人, 低分割放疗

Abstract: Objective To investigate the clinical effects of different dose-fractionations of intensity-modulated radiotherapy for esophageal squamous cell carcinomas in the elderly patients, and to explore the optimal dose-fractionation. Methods A total of 102 elderly patients with esophageal squamous cell carcinoma who received radiotherapy in our hospital from October 2010 to February 2015 were enrolled in this study. According to different dose-fractionations model, all cases were divided into three groups, group A receiving a single radiotherapy dose of 2.0 Gy, 25-30 times in total, with total dose of 50-60 Gy, with a biologically effective dose (BED) of 60-72 Gy; Group B receiving a single radiotherapy dose of 2.2 Gy, 23-27 times in total, with total dose of 50.6-59.4 Gy, with a BED of 61.7-72.5 Gy; Group C receiving a single radiotherapy dose of 2.5 Gy, 19-23 times in total, with total dose of 47.5-57.5 Gy, with a BED of 59.4-71.9 Gy. The adverse reaction rate, local control rate and survival rate of the three groups were analyzed. Results The total effective rate in group A, group B and group C was 82.8%(24/29), 91.7%(44/48) and 96.0%(24/25), resprectively, with no statistically significant difference (P>0.05). There were no significant differences in local control rate for 1-3 years and the survival rates for 1-2 years among the three groups(P>0.05). The 3-year survival rate in group A, group B and group C was 17.2%, 31.3%, 16.0%, respectively, with statistically significant difference (P=0.049). Conclusions Hypofractionated radiotherapy mode (2.2 Gy) in intensity-modulated radiotherapy is an optional radiotherapy scheme for advanced esophageal squamous cell carcinoma in the elderly, but the optimal mode still needs further clinical research.

Key words: esophageal squamous cell carcinomas, aged, hypofractionated radiotherapy

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