[1]蒋聪,梁黎,高绪峰,等.螺旋断层放疗在胸下段食管癌治疗中的应用效果及对患者心肺功能的影响[J].中国医学物理学杂志,2023,40(3):297-302.[doi:DOI:10.3969/j.issn.1005-202X.2023.03.007]
　JIANG Cong,LIANG Li,GAO Xufeng,et al.Therapeutic effect of tomotherapy on lower thoracic esophageal cancer and its influences on cardiopulmonary function[J].Chinese Journal of Medical Physics,2023,40(3):297-302.[doi:DOI:10.3969/j.issn.1005-202X.2023.03.007]
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螺旋断层放疗在胸下段食管癌治疗中的应用效果及对患者心肺功能的影响()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
40卷
期数:
2023年第3期
页码:
297-302
栏目:
医学放射物理
出版日期:
2023-03-29

文章信息/Info

Title:
Therapeutic effect of tomotherapy on lower thoracic esophageal cancer and its influences on cardiopulmonary function
文章编号:
1005-202X（2023）03-0297-06
作者:
蒋聪; 梁黎; 高绪峰; 何友安; 刘秦嵩; 王先良
四川省肿瘤医院放疗中心， 四川 成都 610042
Author(s):
JIANG Cong;  LIANG Li;  GAO Xufeng;  HE Youan;  LIU Qinsong;  WANG Xianliang
Radiotherapy Center, Sichuan Cancer Hospital, Chengdu 610042, China
关键词:
螺旋断层放疗; 胸下段食管癌; 心功能; 肺功能; 治疗效果
Keywords:
Keywords: tomotherapy lower thoracic esophageal cancer cardiac function pulmonary function therapeutic effect
分类号:
R815
DOI:
DOI:10.3969/j.issn.1005-202X.2023.03.007
文献标志码:
A
摘要:
目的：探讨并分析螺旋断层放疗系统（TOMO）在胸下段食管癌治疗中的应用效果及对患者心肺功能的影响。方法：前瞻性选取2016年6月~2020年6月在四川省肿瘤医院确诊并收治的胸下段食管癌患者105例，采用简单随机数表法将其分为观察组（n=53）和对照组（n=52）。对照组患者给予医科达容积调强放疗（VMAT），观察组患者给予TOMO放疗。比较两组食管癌患者临床疗效、靶区剂量学参数和心功能参数。放疗后1年进行随访，记录两组患者生存率和肿瘤复发率。结果：观察组患者临床总有效率为62.26%，显著高于对照组的40.38%（P<0.05）；观察组GTV、PTV的D2、D50、HI均低于对照组，CI高于对照组，差异有统计学意义（P<0.05）；观察组左肺、右肺和双肺V5和Dmean均高于对照组（P<0.05），V30均低于对照组（P<0.05），两组V20比较无显著差异（P>0.05）；放疗后，两组患者血清肌钙蛋白和脑钠肽水平均升高，但观察组低于对照组（P<0.05）；放疗后1年，观察组患者生存率为86.79%，与对照组（82.69%）比较无显著差异（P>0.05）；两组患者复发率比较差异无统计学意义（P>0.05）。结论：TOMO放疗在胸下段食管癌治疗中的疗效较好，可降低对患者心功能的损伤，提高患者生存率，但对肺功能保护不具明显优势。
Abstract:
Abstract: Objective To analyze the curative effect of tomotherapy (TOMO) on lower thoracic esophageal cancer (EC) and to explore its affects on cardiopulmonary function. Methods A total of 105 patients with lower thoracic EC confirmed in Sichuan Cancer Hospital from June 2016 to June 2020 were prospectively enrolled. According to simple random number table method, they were divided into observation group (n=53) and control group (n=52). The patients in control group were treated with volumetric modulated arc therapy (VMAT), while those in observation group received TOMO. The clinical curative effect, target dosimetry parameters, cardiac function parameters and pulmonary function indexes were compared between two groups. At 1 year after radiotherapy, all were followed-up to record survival rates and tumor recurrence rates in both groups. Results The total clinical response rate in observation group was significantly higher than that in control group (62.26% vs 40.38%, P<0.05). The D2, D50 and HI of GTV and PTV in observation group were lower than those in control group (P<0.05), but CI was higher than control group (P<0.05). For the left lung, right lung and both lungs, compared with control group, observation group had higher V5 and Dmean (P<0.05), but lower V30 (P<0.05), and the differences in V20 were trivial (P>0.05). After radiotherapy, the levels of serum troponin and brain natriuretic peptide in both groups were increased, which were lower in observation group than in control group (P<0.05). There was no significant difference between observation group and control group in 1-year survival rate (86.79% vs 82.69%, P>0.05) and recurrence rate (P>0.05). Conclusion The treatment of lower thoracic EC with TOMO is efficient. TOMO can reduce cardiac damages and improve survival rate. However, there is no obvious advantage in pulmonary protection.

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备注/Memo

备注/Memo:
【收稿日期】2022-12-15 【基金项目】四川省科技计划项目（2022YFG0194，2022YFS0047） 【作者简介】蒋聪，研究方向：肿瘤放射治疗技术，E-mail: jiang1cong@126.com 【通信作者】王先良，副研究员，研究方向：医学物理，E-mail: wangliu8687@163.com
更新日期/Last Update: 2023-03-30