【摘要】 目的：研究根治性调强放疗(IMRT)治疗食管癌后食管瘘及出血风险的影响因素。方法：对本院2018年11月～2021年11月行根治性IMRT治疗的70例食管癌患者临床资料进行回顾性分析，根据是否发生食管瘘及出血分为食管瘘及出血组(其中食管瘘7例，食管出血6例)13例和非食管瘘及出血组57例，对食管瘘及出血危险因素行单因素和Logistic多因素分析。结果：食管瘘及出血组大体分型为溃疡型、大体肿瘤靶区(GTV)最大横径>2.45 cm占比显著高于非食管瘘及出血组。多因素logistic回归分析证实，大体分型为溃疡型、GTV最大横径>2.45 cm是根治性IMRT治疗食管癌后食管瘘及出血的独立危险因素。结论：根治性IMRT治疗食管癌后食管瘘及出血的发生与肿瘤大体分型、GTV最大横径有关，临床医师应当予以关注。更多还原

【Abstract】 Objective To study the influence factors of radical intensity modulated radiotherapy (IMRT) on esophageal fistula and bleeding risk after esophageal cancer.Methods The clinical data of 70 patients with esophageal cancer who received radical IMRT treatment in our hospital from November 2018 to November 2021 were retrospectively analyzed,according to the occurrence of esophageal fistula and bleeding,the patients were divided into esophageal fistula and bleeding group (7 cases of esophageal fistula and 6 cases of esophageal bleeding),13 cases and non-esophageal fistula and bleeding group (57 cases).The risk factors of esophageal fistula and bleeding were analyzed by univariate and Logistic multivariate analysis.Results In esophageal fistula and bleeding group,the proportion of ulcer type and the maximum transverse diameter of gross tumor target area (GTV) > 2.45 cm was significantly higher than that in non-esophageal fistula and bleeding group.Multivariate logistic regression analysis confirmed that ulcerated gross type and maximum transverse diameter of GTV > 2.45 cm were independent risk factors for radical IMRT treatment of esophageal fistula and bleeding after esophageal cancer.Conclusion The occurrence of esophageal fistula and hemorrhage after radical IMRT treatment of esophageal cancer is related to the gross classification of tumor and the maximum transverse diameter of GTV,which should be paid attention to by clinicians.更多还原