Deng Wenzhao, Zhang Xueyuan, Su Jingwei, Song Chunyang, Xu Jinrui, Zhao Xiaohan, Shen Wenbin
Department of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.
Front Surg. 2022 May 23;9:905678. doi: 10.3389/fsurg.2022.905678. eCollection 2022.
To analyze and compare the efficacy and safety of simultaneous integrated boost intensity-modulation radiation therapy (SIB-IMRT) combined with systematic and standardized management for esophageal cancer.
From January 2012 to January 2019, 200 patients with esophageal cancer who received radical chemoradiotherapy in our hospital were treated with lymphatic drainage area radiation prevention combined with systematic and standardized management. According to difference in radiotherapy methods, the patients were divided into local lesion 92 patients treated with simultaneous integrated boost intensity-modulation radiation therapy (SIB-IMRT) combined with systematic standardized management (SIB-IMRT group), and late course boost intensity-modulation radiation therapy (LCB-IMRT) combined with systematic standardized management 108 patients (LCB-IMRT group). The short-term eficacy of the two groups were compared. The dose volume parameters of the organ in danger are evaluated based on the dose volume histogram. The related adverse reactions during chemoradiotherapy were compared between two groups. The local control rate and survival rate were compared between the two groups.
The recent total effective rates of rats in the SIB-IMRT group and LCB-IMRT group were 95.65% and 90.74%, respectively, and there was no significant difference between the two groups (> 0.05). The mean doses to left and right lung, heart and spinal cord in the SIB-IMRT group were significantly lower than that in the LCB-IMRT group (< 0.05). There was no significant difference in the incidence of adverse reactions such as radiation esophagitis, radiation pneumonitis, radiation tracheitis, gastrointestinal reaction and bone marrow suppression between the SIB-IMRT group and LCB-IMRT groups (> 0.05). The one-year and three-year overall survival rates in the SIB-IMRT group and LCB-IMRT groups were 82.61%, 42.39% and 77.78%, 34.26%, respectively, and the median survival times were 38 and 29 months, respectively. The local control rates in the SIB-IMRT group and LCB-IMRT group in one and three years were 84.78%, 56.52% and 75.93%, 41.67%, respectively. The 3-year local control rate in the SIB-IMRT group was higher than that in the LCB-IMRT group (< 0.05), but there was no significant difference in the 1-and 3-year overall survival rates between the two groups (> 0.05).
SIB-IMRT combined with systematic and standardized management in the treatment of esophageal cancer can reduce the amount of some organs at risk and improve the local control rate of the lesion.
分析比较同步整合加量调强放射治疗（SIB-IMRT）联合系统规范化管理用于食管癌治疗的疗效及安全性。
选取2012年1月至2019年1月在我院接受根治性放化疗的200例食管癌患者，均采用淋巴引流区预防照射联合系统规范化管理。根据放疗方法的不同，将患者分为局部病变采用同步整合加量调强放射治疗（SIB-IMRT）联合系统规范化管理的92例患者（SIB-IMRT组），以及采用后程加量调强放射治疗（LCB-IMRT）联合系统规范化管理的108例患者（LCB-IMRT组）。比较两组的近期疗效。基于剂量体积直方图评估危及器官的剂量体积参数。比较两组放化疗期间的相关不良反应。比较两组的局部控制率和生存率。
SIB-IMRT组和LCB-IMRT组近期总有效率分别为95.65%和90.74%，两组比较差异无统计学意义（>0.05）。SIB-IMRT组左、右肺、心脏及脊髓的平均剂量均显著低于LCB-IMRT组（<0.05）。SIB-IMRT组与LCB-IMRT组放射性食管炎、放射性肺炎、放射性气管炎、胃肠道反应及骨髓抑制等不良反应发生率比较，差异无统计学意义（>0.05）。SIB-IMRT组和LCB-IMRT组1年、3年总生存率分别为82.61%、42.39%和77.78%、34.26%，中位生存时间分别为38个月和29个月。SIB-IMRT组和LCB-IMRT组1年、3年局部控制率分别为84.78%、56.52%和75.93%、41.67%。SIB-IMRT组3年局部控制率高于LCB-IMRT组（<0.05），但两组1年、3年总生存率比较差异无统计学意义（>0.05）。
SIB-IMRT联合系统规范化管理用于食管癌治疗可减少部分危及器官受量，提高病变局部控制率。
