图像引导调强放疗治疗胸段食管癌的摆位误差分析及疗效观察

目的 研究图像引导调强放疗（IGRT）治疗胸段食管癌的摆位误差及疗效. 方法选择170例胸段食管癌患者,年龄46～69岁.将患者随机分为IGRT组（86例）和IMRT组（84例）.两组分别接受图像引导放疗和图像调强放疗. 结果 IGRT组患者摆位误差被纠正后同纠正前相比,X轴、Y轴及Z轴误差分别少于纠正前（分别P ＜ 0.05,P ＜ 0.05,P ＜ 0.01）.摆位误差对累及器官和靶区剂量分布影响比较大.IGRT组和IMRT组0级＋Ⅰ级上呼吸道反应比例分别为76.7%（66/86）和56.0%（47/84）,IGRT组明显高于IMRT组,差异有统计学意义（P ＜ 0.05）;IGRT组和IMRT组0级＋Ⅰ级上消化道反应比例分别为74.4%（64/86）和57.1%（48/84）,IGRT组高于IMRT组,差异有统计学意义（P ＜ 0.05）.两组患者有效率相接近（P ＞ 0.05）. 结论 IGRT治疗食管癌可以明显纠正和降低摆位误差,并增强累及器官和靶区剂量分布的精确性.IGRT可将治疗过程中的毒副作用降低,且治疗食管癌的疗效较佳.

The set-up error analysis and curative effect observation of the image-guided radiation therapy in treating thoracic segment esophageal cancer

Objective To study the set-up error and curative effect of the image-guided radiation therapy in treating thoracic segment esophageal cancer. Methods A total of 170 thoracic segment esophageal cancer patients, aged from 46 years to 69 years, were selected as the study objects. 170 patients were randomly divided into group IGRT （86 pa- tients） and group IMRT （84 patients）. The two groups received image guided radiotherapy and intensity modulated radiation therapy, respectively. Results The X axis, Y axis and Z axis error in group IGRT after set-up error corrected were less than that before set-up error corrected （P 〈 O.05,＇P 〈 0.05, P 〈 0.01 respectively）. The effect of the set-up error on the involved organs and target dose distribution was large. The upper respiratory tract response （level 0 ＋ level I ） rates in group IGRT and group IMRT were 76.7%（66/86）and 56.0%（47/84）, respectively. The rate of group I- GRT was significantly higher than group IMRT （P 〈 0.01）. The upper gastrointestinal tract reaction （level 0 ＋ level I ） rates in group IGRT and group IMRT were 74.4% （64/86） and 57.1% （48/84）, respectively. The rate of group IGRT was significantly higher than group IMRT （P 〈 0.05）. The efficient rates in the two groups were similar （P 〉 0.05）. Conclusion The image-guided radiation therapy treating esophageal cancer can correct and downregulate set-up error, and enhance the accuracy of dose distribution of the target cancer and involved organs. Image-guided radiation therapy can reduce side effects in the treatment process, and curative effect of image-guided radiation therapy treating esophageal cancer is good.