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食管癌三维适形放疗疗效和靶区勾画与局部复发关系的探讨

Three-dimensional conformal radiation therapy in treatment of esophageal carcinoma and relationship between the delineation of target volume and local recurrence

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【作者】 杨哲颜廷秀洪士强梁荣祥

【Author】 YANG Zhe,YAN Ting-xiu,HONG Shi-qiang,LIANG Rong-xiang Cancer Center,Shandong Provincial Hospital,Jinan 250021,P.R.China

【机构】 山东省立医院肿瘤中心

【摘要】 目的:通过分析三维适形放疗的临床结果,初步探讨食管癌靶体积勾画的合理性。方法:共46例行三维适形放疗的食管癌患者进入研究。将靶体积分为大体肿瘤体积(GTV)、临床靶体积(CTV)和计划靶体积(PTV)。处方剂量PTV60~70Gy。采用Kaplan-Meier计算局部区域无进展生存率和总生存率。对比疗前和疗后CT,判断肿瘤复发或未控位于野内、野外或边缘。复发的部位在90%剂量曲线内定义为野内复发,在90%和50%剂量曲线内定义为边缘复发,50%剂量曲线外定义为野外复发。结果:1和2年局部区域无进展生存率分别为67.4%和49.9%,总生存率分别为和76.1%和58.7%。野内、边缘、野外复发或未控分别为50.0%、18.7%和31.3%。结论:该靶体积划定方法是比较合理的,但仍需进一步研究。

【Abstract】 OBJECTIVE: To discuss the clinical effect in three dimensional conformal radiation therapy(3DCRT) for esophageal carcinoma and evaluate the delineation of rational target volume.METHODS: Forty-six patients with esophageal carcinoma were treated with 3DCRT.The target volume was described as the gross tumor volume and the clinical target volume,the planning target volume.The prescribed dose to PTV was 60-70 Gy.Kaplan-Meier statistical method was used to calculate the locoregional progression-free and overall survival rate.The local recurrence was evaluated in port,marginal and outside as comparing CT before and after the radiotherapy.Local recurrence was classified as in port,marginal and outside.In port local recurrence was within the 90% isodose;marginal was within the 50% to 90% isodose;outside was without the 50% isodose.RESULTS: The 1-,2-year locoregional control survival rates were 67.4% and 49.9%,respectively.The overall survival rates were 76.1% and 58.7%.Among the local recurrent patients,50.0% were in port,18.7% were marginal,and 31.3% were outside.CONCLUSION: The method of defining the target volume is reasonable for esophageal carcinoma,but further study should be warranted.

  • 【文献出处】 中华肿瘤防治杂志 ,Chinese Journal of Cancer Prevention and Treatment , 编辑部邮箱 ,2008年12期
  • 【分类号】R735.1
  • 【被引频次】28
  • 【下载频次】304
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