【摘要】 目的:比较累及野照射(IFI)和选择性淋巴引流区预防性照射(ENI)治疗老年食管癌的疗效及副反应,为老年食管癌患者放疗靶区勾画提供参考。方法:回顾性分析安徽医科大学第一附属医院肿瘤放疗科126例年龄≥70岁的食管癌患者资料,其中男性90例,女性36例;全组中位随访时间20个月。分析比较两种照射方法治疗的患者疗效、副作用及失败模式等。结果:采用IFI者79例(62.7%),采用ENI者47例(37.3%)。ENI组和IFI组的1、2、3年总生存率(OS)分别为82.0%、40.7%、31.7%和68.7%、39.2%、16.9%,差异无统计学意义(P>0.05);IFI组中位无进展生存期(PFS)(10个月)与ENI组(13个月)间差异无统计学意义(P>0.05)。IFI组发生放射性食管炎者低于ENI组(P<0.05),而两组发生放射性肺炎者差异无统计学意义(P>0.05)。IFI组患者野内复发率(32.9%)、远处转移率(24.1%)、野内复发同时合并远处转移率(6.3%)与ENI组(40.4%、34.0%和10.6%)比较差异均无统计学意义(P>0.05)。结论:老年食管癌患者两种照射方法疗效相似,IFI组放射性食管炎发生率更低,可能更适合≥70岁的老年食管癌患者。更多还原

【Abstract】 Objective:To determine an appropriate target delineation model for elderly patients with esophageal squamous cell cancer(ESCC) via retrospectively comparing the efficacy and side effects of the involved-field irradiation(IFI) and the elective nodal irradiation(ENI).Methods:The clinical data were obtained from elderly ESCC patients ≥70 years old(90 males and 36 females;median follow-up:20 months) admitted to our hospital,whose tumors were unresectable or who were unwilling to undergo surgery and retrospectively analyzed regarding the efficacy,side effects and the factors affecting prognosis between and IFI group and ENI group.Results:A total of 126 eligible cases were included,79(62.7%) of whom received IFI and 47(37.3%) ENI.The 1-year,2-year and 3-year overall survival rates were 82.0%,40.7% and 31.7% in the ENI group,68.7%,39.2% and 16.9% in IFI group,respectively.The difference was insignificant between groups(P>0.05).The progression-free survival between IFI(10 months) and ENI(13 months) group had no significant difference(P>0.05).Radioactive esophagitis was much less serious in patients in the IFI group than those in the ENI group(P<0.05),yet the difference was insignificant in the severity of radioactive pneumonia between the two groups(P>0.05).There was also no significant difference between IFI group and ENI group concerning the ratio of field recurrence,distant metastasis and field recurrence plus distant metastasis(32.9%,24.1% and 6.3% vs. 40.4%,34.0% and 10.6%,respectively)(P>0.05).Conclusion:The efficacy of IFI is similar to that of ENI in the treatment of elderly ESCC patients,yet the former has significantly lower radiation esophagitis effects,suggesting that involved-field radiotherapy may be preferable for elderly ESCC patients aged 70 year or over.更多还原