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目的评价调强放疗(IMRT)与传统放疗(BOX)在胸段食管癌放射治疗中的临床应用效果。方法 22例食管癌患者分别采用IMRT与BOX进行放射治疗,比较IMRT和BOX在胸段食管癌放疗中应用时在靶区适形度以及危及器官受照射剂量方面的疗效。结果 IMRT和BOX的靶区覆盖分别为(95.61±0.60)%和(95.49±0.42)%。IMRT的适形指数为0.85±0.04,高于BOX的0.78±0.03(P<0.01);而IMRT均匀指数为0.89±0.01,低于BOX的0.91±0.01(P<0.01)。IMRT减少了20Gy剂量所覆盖的肺体积(V20)和肺平均剂量,却增加了5Gy剂量所覆盖的肺体积(V5);IMRT同时减少了心脏和脊髓的受照射剂量。结论 IMRT在获得较高靶区适形度的同时能很好地保护心脏、肺、脊髓等危及器官,但应注意肺低剂量受照射区域的增加。
Objective To evaluate the clinical effects of IMRT and conventional radiotherapy in radiotherapy of thoracic esophageal cancer. Methods Twenty-two patients with esophageal cancer underwent radiotherapy with IMRT and BOX respectively. The curative effect of IMRT and BOX on the conformality of the target area and the organ-exposed dose in radiotherapy of thoracic esophageal cancer was compared. Results The target area covered by IMRT and BOX were (95.61 ± 0.60)% and (95.49 ± 0.42)%, respectively. The conformal index of IMRT was 0.85 ± 0.04, higher than that of BOX 0.78 ± 0.03 (P <0.01). The IMRT even index was 0.89 ± 0.01, lower than that of BOX 0.91 ± 0.01 (P <0.01). IMRT reduced the lung volume (V20) and mean lung dose covered by the 20 Gy dose but increased the lung volume (V5) covered by the 5 Gy dose; IMRT also reduced the irradiated dose to the heart and spinal cord. Conclusions IMRT can protect the organs such as the heart, lung and spinal cord well while obtaining the conformality of higher target area. However, it should be noted that the low dose of lungs is increased in the irradiated area.