食管癌放疗后局部复发45例再程调强放疗分析

何斌; 殷红梅; 崔珍; 楼建军; 江浩; 沈学明

doi:10.13898/j.cnki.issn.1000-2200.2015.01.007

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食管癌放疗后局部复发45例再程调强放疗分析

何斌 , 殷红梅 , 崔珍 , 楼建军 , 江浩 , 沈学明

文章导航 > 蚌埠医学院学报 > 2015, 40 > 1: (23-25)

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食管癌放疗后局部复发45例再程调强放疗分析

蚌埠医学院第一附属医院放疗科, 安徽蚌埠 233004

作者简介: 何斌(1979-),男,主治医师.

基金项目:
安徽省十二五临床医学重点专科建设基金资助项目(01Z33)
中图分类号: R735.1

Analysis of intensity-modulated radiation therapy in 45 patients with local recurrence of esophageal cancer after radiotherapy

Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R735.1

摘要: 目的:分析食管癌放疗后局部复发患者再程调强放疗(IMRT)的可行性、近期疗效、不良反应及相关因素.方法:45例食管癌首程放疗后局部复发患者,采用IMRT行再程放疗,每次1.8~2.0 Gy,5次/周,照射剂量不等,总剂量45~60 Gy,中位剂量50.4 Gy.结果:45例患者中42例完成放疗,完全缓解8例,部分缓解27例,病情稳定7例;2级放射性食管炎18例,3级2例,2级放射性肺炎7例,3级1例,经积极治疗后症状缓解;5例于放疗后3个月内出现食管穿孔,半年内病死;3例因病情恶化而终止放疗,1例放疗后半年因肺部大出血死亡.全组1、2年总生存率分别为40.0%和17.8%,其中完全缓解者均生存2年以上.结论:食管癌放疗后局部复发患者IMRT为有效的治疗手段,有一定的临床客观缓解率,但放疗并发症亦较高,应警惕食管穿孔及3级以上放射性肺炎的发生.
- 食管肿瘤 /
- 放射治疗 /
- 调强放疗
Abstract: Objective:To evaluate the feasibility, short-term curative effect, adverse reaction and its related factors of intensity-modulated radiation therapy(IMRT) in patients with local recurrence of esophageal cancer after radiotherapy.Methods:Forty-five patients with local recurrence of esophageal cancer after radiotherapy were treated with 1.8 to 2.0 Gy of IMRT 5 times a week, a median total dose for 50.4 Gy(range from 45 to 60 Gy).Results:Among 45 patients, the re-irradiation therapy in 42 patients were completed, complete response in 8 cases, partial response in 27 cases and stable disease in 7 cases were found.Grade 2 and grade 3 acute radiation esophagitis occurred in 18 cases and 2 cases, respectively.Grade 2 and grade 3 acute radiation pneumonitis occurred in 7 cases and 1 case, respectively, and the patients relieved after active treatment.Five patients occurred the perforation of esophagus in 3 months after radiotherapy, and died within 6 months.Three patients terminated the radiation because of the general deterioration, 1 patient died because of pneumorrhagia in six months after radiotherapy.The total survival rates of 1 and 2-year were 40.0% and 17.8%, respectively.The patients with complete remission survived over 2 years.Conclusions:The treatment of patients with local recurrence of esophageal cancer after radiotherapy with IMRT is effective, which has certain remission rate and high complication.The perforation of esophagus and more than grade 3 radiation pneumonitis should be alerted.
- esophageal neoplasm /
- radiation /
- intensity-modulated radiation therapy

[1]	肖泽芬.食管癌[M]//殷蔚伯,谷铣之.肿瘤放射治疗学.4版.北京:中国协和医科大学出版社,2008:546-577.
[2]	Nonoshita T,Sasaki T,Hirata H,et al.High-dose-rate brachytherapy for previously irradiated patients with recurrent esophageal cancer[J].Radiat Med,2007,25(8):373-377.
[3]	Jin J,Xu X,Wang F,et al.Second-line combination chemotherapy with docetaxel and nedaplatin for Cisplatin-pretreated refractory metastatic/recurrent esophageal squamous cell carcinoma[J].Thorac Oncol,2009,4(8):1017-1021.
[4]	Tahara M,Ohtsu A,Hironaka S,et al.Clinical impact of criteria for complete response(CR) of primary site to treatment of esophageal cancer[J].Jpn J Clin Oncol,2005,35(6):316-323.
[5]	Jereczek-Fossa1 BA,Kowalczyk A,D'onofrio A,et al.Three-dimensional conformal or stereotactic reirradiation of recurrent metastatic or new primary tumors.Analysis of 108 patients [J].Strahlenther Onkol,2008,184(1):36-40.
[6]	黄辉,郭明,王友军,等.三维适形在中段食管癌放疗中的应用[J].现代肿瘤医学,2006,14(8):958-960.
[7]	蒋国梁.束流调强的适形立体放射治疗[J].中国癌症杂志,1997,7(2):142-145.
[8]	吴开良.放射治疗后肿瘤复发的再程治疗[J].中华放射肿瘤学杂志,2003,12(4):258-260.
[9]	Kim YS,Lee CG,Kim KH,et al.Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy[J].Radiat Oncol.2012,30(4):182-188.
[10]	Yamaguchi S,Ohguri T,Imada H,et al Multimodal approaches including three-dimensional conformal re-irradiation for recurrent persistent esophageal cancer:preliminary results[J].Radiat Res,2011,52(6):812-820.
[11]	戴晓萍.食管癌放疗后局部复发的再程治疗[J].长治医学院学报,2004,18(4):282-283.
[12]	罗宏涛,魏世鸿,王小虎,等.食管癌放疗后复发再程三维适形放疗同步化疗的临床观察[J].中华肿瘤防治杂志,2013,5(7):371-373.
[13]	沈文斌,祝淑钗,万钧,等.42例放疗后复发食管癌三维适形放疗的疗效分析[J].中华放射肿瘤学杂志,2010,19(2):111-113.

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食管癌放疗后局部复发45例再程调强放疗分析

作者简介: 何斌(1979-),男,主治医师.

蚌埠医学院第一附属医院放疗科, 安徽蚌埠 233004

收稿日期: 2014-01-10

基金项目: 安徽省十二五临床医学重点专科建设基金资助项目(01Z33)

关键词:

摘要: 目的:分析食管癌放疗后局部复发患者再程调强放疗(IMRT)的可行性、近期疗效、不良反应及相关因素.方法:45例食管癌首程放疗后局部复发患者,采用IMRT行再程放疗,每次1.8~2.0 Gy,5次/周,照射剂量不等,总剂量45~60 Gy,中位剂量50.4 Gy.结果:45例患者中42例完成放疗,完全缓解8例,部分缓解27例,病情稳定7例;2级放射性食管炎18例,3级2例,2级放射性肺炎7例,3级1例,经积极治疗后症状缓解;5例于放疗后3个月内出现食管穿孔,半年内病死;3例因病情恶化而终止放疗,1例放疗后半年因肺部大出血死亡.全组1、2年总生存率分别为40.0%和17.8%,其中完全缓解者均生存2年以上.结论:食管癌放疗后局部复发患者IMRT为有效的治疗手段,有一定的临床客观缓解率,但放疗并发症亦较高,应警惕食管穿孔及3级以上放射性肺炎的发生.

English Abstract

Analysis of intensity-modulated radiation therapy in 45 patients with local recurrence of esophageal cancer after radiotherapy

Department of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2014-01-10

Abstract: Objective:To evaluate the feasibility, short-term curative effect, adverse reaction and its related factors of intensity-modulated radiation therapy(IMRT) in patients with local recurrence of esophageal cancer after radiotherapy.Methods:Forty-five patients with local recurrence of esophageal cancer after radiotherapy were treated with 1.8 to 2.0 Gy of IMRT 5 times a week, a median total dose for 50.4 Gy(range from 45 to 60 Gy).Results:Among 45 patients, the re-irradiation therapy in 42 patients were completed, complete response in 8 cases, partial response in 27 cases and stable disease in 7 cases were found.Grade 2 and grade 3 acute radiation esophagitis occurred in 18 cases and 2 cases, respectively.Grade 2 and grade 3 acute radiation pneumonitis occurred in 7 cases and 1 case, respectively, and the patients relieved after active treatment.Five patients occurred the perforation of esophagus in 3 months after radiotherapy, and died within 6 months.Three patients terminated the radiation because of the general deterioration, 1 patient died because of pneumorrhagia in six months after radiotherapy.The total survival rates of 1 and 2-year were 40.0% and 17.8%, respectively.The patients with complete remission survived over 2 years.Conclusions:The treatment of patients with local recurrence of esophageal cancer after radiotherapy with IMRT is effective, which has certain remission rate and high complication.The perforation of esophagus and more than grade 3 radiation pneumonitis should be alerted.