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中华放射肿瘤学杂志
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中华放射肿瘤学杂志  2015, Vol. 24 Issue (6): 615-618    DOI: 10.3760/cma.j.issn.1004-4221.2015.06.003
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早期食管癌根治性放射治疗不同照射范围的比较研究
祝淑钗,董辉,刘志坤,沈文斌,李娟,苏景伟,许金蕊
050011 石家庄,河北医科大学第四医院放疗科
A comparative study of different irradiation ranges in radical radiotherapy for early-stage esophageal cancer
Zhu Shuchai,Dong Hui,Liu Zhikun,Shen Wenbin,Li Juan,Su Jingwei,Xu Jinrui
Department of Radiation Oncology,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China
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摘要 目的 比较早期食管癌根治性放射治疗中ENI与IFI的疗效, 寻找早期食管癌适合的放射治疗范围。方法 搜集2006—2011年间在我院接受根治性放射治疗的121例早期食管癌患者资料, 其中接受ENI者61例, 接受IFI者60例。采用Kaplan-Meier法计算LC、OS并Logrank法检验和单因素预后分析, Cox模型多因素预后分析。结果 ENI组与IFI组1、3、5年LC率分别为81.1%、60.1%、57.5%与64.5%、43.9%、27.2%(P=0.003), OS率分别为86.9%、56.8%、34.8%和86.7%、34.3%、19.1%(P=0.019), 失败率分别为22.3%、53.8%、63.2%与43.3%、65.8%、78.8%(P=0.023)。多因素分析显示照射范围是影响患者LC、OS的因素。结论 早期食管癌根治放射治疗行ENI可显著降低局部区域失败, 提高LC, 进而改善长期OS。
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祝淑钗
董辉
刘志坤
沈文斌
李娟
苏景伟
许金蕊
关键词 食管肿瘤/放射疗法选择性淋巴引流区预防照射累及野照射预后    
AbstractObjective To compare the efficacy of elective nodal prophylactic irradiation (ENI) and involved-field irradiation (IFI) in radical radiotherapy for early-stage esophageal cancer and to determine the appropriate irradiation range for early-stage esophageal cancer. Methods The clinical data of 121 patients with early-stage esophageal cancer receiving radical radiotherapy in our hospital from January 2006 to December 2011 were collected and respectively analyzed. Sixty-one patients received ENI, and the other 60 patients received IFI. The Kaplan-Meier method was used to calculate local control (LC) and overall survival (OS) rates;the log-rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The 1-, 3-, and 5-year LC rates in ENI group and IFI group were 81.1%, 60.1%, and 57.5% vs. 64.5%, 43.9%, and 27.2%, respectively (P=0.003). The 1-, 3-, and 5-year OS rates in ENI group and IFI group were 86.9%, 56.8%, and 34.8% vs. 86.7%, 34.3%, and 19.1%, respectively (P=0.019). The 1-, 3-, and 5-year overall failure rates in ENI group and IFI group were 22.3%, 53.8%, and 63.2% vs. 43.3%, 65.8%, and 78.8%, respectively (P=0.023). Multivariate analysis showed that irradiation range was the influencing factor for LC and OS. Conclusions As for the radical radiotherapy for early-stage esophageal cancer, ENI can significantly increase LC and reduce locoregional failure, and therefore improve long-term OS.
Key wordsEsophageal neoplasms/radiotherapy    Elective nodal prophylactic irradiation    Involved-field irradiation    Prognosis   
    
基金资助:河北省卫生厅医学适用技术跟踪项目(GL200848)
引用本文:   
祝淑钗,董辉,刘志坤等. 早期食管癌根治性放射治疗不同照射范围的比较研究[J]. 中华放射肿瘤学杂志, 2015, 24(6): 615-618.
Zhu Shuchai,Dong Hui,Liu Zhikun et al. A comparative study of different irradiation ranges in radical radiotherapy for early-stage esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2015, 24(6): 615-618.
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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2015.06.003     或     http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2015/V24/I6/615
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