|
Objective: To compare N0 thoracic esophageal tumor edge by according to the relationship between dose and survival rate, derived target appropriate dose range. Methods: January 2004 to December 2008 in our hospital during the N0 stage thoracic esophageal initial treatment 72 patients, pathology are squamous cell carcinoma. Where I, IIa, 33 cases of III, 33 cases; 14 cases the previous paragraph, the middle of the 48 cases, 10 cases of the following paragraph. Conventional irradiation of 1.8 ~ 2Gy /, 5 times / week, total dose DT 56Gy-70Gy, median dose 62Gy. In addition, the edge of the left, right, front, dorsal tumor diameter maximum level TPS treatment planning system to identify, read 0.5cm, 1cm, 1.5cm, 2cm at the value of the exposure doses, head, feet and side for CT tumor disappeared The first level, up and down the 0.9cm (3-layer), 2.1cm (7 layers), 3.0cm (10 layers), 3.9cm (13 layers) at the exposed dose value. SPSS13.0 statistical package for statistical analysis, Kaplan-Meier method to calculate survival rates by Log-rank test differences between groups. P lt; 0.05 determined to be statistically significant. Results: (1) the primary tumor (GTV) by radiation doses ≤ 60Gy gt; Gy to 60 Gy was aimed at the 1 -, 2 - and 3-year survival rate was no statistical difference (χ2 = 0.534, P = 0.465). (2) the left side of the primary tumor 0.5cm at 1, 2 and 3-year survival rate of 63 ~ 67Gy irradiation compared with the lt; 63Gy and gt; 67Gy group, and 63 ~ 67Gy group and lt; 63Gy group statistically significant difference (χ 2 = 5.982, P = 0.014). Show: tumor left at 0.5cm accepts 63 ~ 67Gy irradiation dose is appropriate; the left side of the primary tumor 1.0cm accepted gt; 62Gy irradiation ≤ 62Gy 1,2,3-year survival rate (χ2 = 4.585 , P = 0.032). Show: the tumors left side 1.0cm accepting gt; 62Gy irradiation dose is appropriate; the left side of the primary tumor 1.5cm accepted gt; 58Gy ≤ 58Gy 1, 2 and 3-year survival rate was no significant difference (χ2 = 1.321, P = 0.250). Primary tumor of the left 2.0cm accepted gt; 41Gy irradiation of 1,2,3-year survival rate is higher than ≤ 41Gy (χ 2 = 4.728, P = 0.030). Show: tumor at the left side of 2.0cm to accept not less than 41Gy irradiation dose is appropriate. (3) the right side of the primary tumor 0.5cm at 1, 2 and 3-year survival rate of 60 ~ 64Gy irradiation compared with the lt; 60Gy and gt; the 64Gy those, 60 ~ 64Gy group and lt; Gy to 60 Gy was aimed at group differences statistical significance (χ 2 = 3.958, P = 0.047). Show: tumor right at 0.5cm accepts 60 ~ 64Gy irradiation dose is appropriate. Primary tumor of the right side of 1.0cm receiving gt; to 61Gy irradiation by the 1, 2 and 3-year survival rate compared with ≤ 61Gy by (χ 2 = 4.568, P = 0.033). Show: tumor at the right side of 1.0cm accepted gt; 61Gy irradiation dose is appropriate. Primary tumor of the right side of 1.5cm receiving gt; the 56Gy's 1, 2 and 3-year survival rate was significantly higher than those of ≤ 56Gy (χ 2 = 3.971, P = 0.046). Show: tumor at the right side of 1.5cm accepted gt; 56Gy irradiation dose is appropriate. Primary tumor of the right side of 2.0cm accepted gt; the 44Gy 1,2,3 year survival rate is higher than the ≤ 44Gy (χ 2 = 3.897, P = 0.048). Show: tumor right side 2.0cm gt; 44Gy irradiation dose is appropriate. (4) The front side of the primary tumor at 0.5cm and accept the 1 -, 2 - and 3-year survival rate of 62 ~ 65Gy irradiation is higher than gt; 65Gy and the lt; 62Gy by lt; 62Gy difference statistics significance (χ 2 = 4,525, p = 0.033). Show: the tumor front side at 0.5cm accepts 62 ~ 65Gy irradiation dose is appropriate. The front side of the primary tumor 1.0cm Department to accept the 1 -, 2 - and 3-year survival rate of 61 ~ 64Gy irradiation group than gt; 64Gy and the lt; 61Gy by and with the lt; compared to 61Gy group difference was statistically significant (χ2 = 4.436, P = 0.035). : The tumor front side 1.0cm Department accepts 61 ~ 64Gy irradiation dose is appropriate. 1 -, 2 - and 3-year survival rate is higher than the front side of the primary tumor 1.5cm, accepts 62 ~ 66Gy irradiation at the lt; 62Gy and gt; 66 Gy (χ2 = 6.108, P = 0.047). : Accept the the tumor front side 1.5cm at 62 ~ 66Gy irradiation dose is appropriate. The front side of the primary tumor 2.0cm at acceptance lt; 56Gy, 56 to 63Gy and gt; 63Gy irradiation of 1,2,3-year survival rate was no significant difference (χ2 = 1.614, P = 0.466). (5) the primary tumor the dorsal 0.5cm at the 1 -, 2 - and 3-year survival rate of 61 ~ 66Gy irradiation than gt; 66 Gy and the lt; 61Gy, and the difference was statistically compared with the lt; 61Gy significance (χ2 = 4.40, P = 0.036). Show: tumor at the dorsal 0.5cm accepts 61 ~ 66Gy irradiation dose is appropriate. Original the fat tumor the dorsal 1.0cm at 60 ~ 64Gy irradiation of 1 -, 2 - and 3-year survival rate than gt; 64Gy and the lt; 60Gy, and lt; Gy to 60 Gy was aimed at group compared the difference was statistically significant (χ2 = 4.422, P = 0.035). Show: tumor at the dorsal 1.0cm receive a radiation dose of 60 ~ 64Gy appropriate. Primary tumor dorsal 1.5cm at receiving lt; 52Gy, 52-59Gy gt; 59Gy irradiation of 1, 2 and 3-year survival rate was no significant difference (χ2 = 2.723, P = 0.256). Primary tumor dorsal 2.0cm at the accepted gt; the 51Gy's 1 -, 2 -, and 3-year survival rate was higher than ≤ 51Gy by (χ 2 = 4.599, P = 0.032). Show: tumor dorsal 2.0cm the Department accepted gt; 51Gy irradiation dose is appropriate. (6) primary tumor cephalad 0.9cm, 3.9cm at 1, 2 and 3-year survival rate received different doses of irradiation did not show a statistically significant difference (χ2 = 2.505,1.721; P = 0.286,0.423). Primary tumor the cephalic 2.1cm at the 1 -, 2 - and 3-year survival rate of 56 ~ 62Gy irradiation than gt; 62Gy lt; 56Gy by and with the lt; compared to 56Gy group, the difference was statistically significant ( χ2 = 5.17, P = 0.023). Show: tumor the cephalic 2.1cm at receive a radiation dose of 56 ~ 62Gy appropriate. Primary tumor the cephalic 3.0cm at, to accept the 1 -, 2 - and 3-year survival rate of 48 ~ 54Gy irradiation is higher than gt; 54Gy lt; 48Gy and gt; 54Gy group compared the difference was statistically significant difference (χ2 = 4.07, P = 0.044). Show: tumor the cephalic 3.0cm at the need of 48 ~ 54Gy irradiation dose. (7) primary tumor foot side 0.9cm, 2.1cm Department received different doses of irradiation, 1 -, 2 - and 3-year survival rate difference was not statistically significant (χ2 = 0.127,1.001; P = 0.938,0.606). But, 3.0cm at the primary tumor foot side to accept the 1 -, 2 - and 3-year survival rate of 49 ~ 56Gy irradiation than gt; 56Gy and lt; 49Gy those in and lt; 49Gy compared to the difference was statistically significant ( χ2 = 4.696, P = 0.030). Show: accept tumor foot side 3.0cm at 49 ~ 56Gy irradiation dose. 1 -, 2 - and 3-year survival rate is higher than the primary tumor foot side 3.9cm at 38 ~ 46Gy irradiation gt; 46Gy and lt; 38Gy by and with the lt; 38Gy who compared the difference was statistically significant (χ2 = 4.181, P = 0.041). The Show: tumor foot at the side 3.9cm receive a radiation dose of 38 ~ 46Gy appropriate. Conclusion: We believe that a more appropriate target dose of thoracic esophageal cancer: a tumor around 0.5cm at the given radiation dose of 63 ~ 64Gy; the 1.0cm accepting irradiation dose of 62 ~ 64Gy, 2.0cm Department gt; 51Gy irradiation dose of appropriate; 2 tumor the cephalic 2.1cm at accepts 56 ~ 62Gy irradiation dose the 3.0cm accepting 48 ~ 54Gy irradiation dose is appropriate; 3 tumors feet at the side 3.0cm accepts 49 ~ 56Gy irradiation dose and 3.9cm at 38 ~ 46Gy irradiation dose is appropriate.
|