中文摘要：

目的 探讨食管癌放射治疗的并发症及其防治方法,为食管癌的治疗提供科学依据.方法 选择浙江省金华市中心医院2010年3月～2012年10月收治的食管癌患者71例,随机分为3组,分别给予常规放疗（CRT）、（CRT组,n=24）、调强放疗（IMRT） （IMRT组,n=23）和三维适形放疗（3D-CRT）（3D-CRT组,n=24）,总剂量均为60 Gy.观察不同放疗组靶器官的受线量,各种并发症发生情况.结果 ①3D-CRT组患者肺、心脏和脊髓接受的放射线的剂量[（27.45±10.01）、（15.89±11.12）、（20.37±3.01）Gy]明显低于CRT组[（38.02±11.22）、（25.65±4.89）、（28.58±3.72）Gy]和IMRT组[（33.98±11.43）、（20.98±10.01）、（29.89±3.04）Gy],差异有统计学意义（P＜0.05）.②IMRT组和3D-CRT组放射性食管炎的发生率明显高于CRT组（P＜0.05）,放射性肺炎和放射性气管炎的发生率明显低于CRT组,差异有统计学意义（P＜0.05）.③IMRT组和3D-CRT组患者白细胞减少发生率低于CRT组,而白细胞未减少的概率高于CRT组,差异均有高度统计学意义（P＜0.01）.结论 3种治疗计划均能满足靶区剂量要求,但IMRT和3D-CRT对周围的正常组织的伤害小,引起的并发症比较轻,适合广泛推广.

英文摘要：

Objective To discuss the prevention and complications of different radiation pattern in esophagus cancer. Methods 71 cases of esophageal cancers from March 2010 to October 2012 in Central Hospital of Jinhua City were selected and randomly divided into 3 groups. 24 cases were treated with conventional radiotherapy （CRT） as CRT group, 23 cases were treated with intensity modulated radiation therapy （IMRT） as IMRT group, 24 cases were treated with three dimensional conformal radiation therapy （3D-CRT） as 3D-CRT group. Total dose all were 60 Gy. The radi- ation dose of target organs, the complications in 3 groups were observed. Results @The radiation dose of lung, heart, marrow tissue of 3D-CRT group [（27.45±10.01）, （15.89±11.12）, （20.37±3.01） Gy] were lower than those of CRT group [（38.02±11.22）, （25.65±4.89）, （28.58±3.72） Gy] and IMRT group [（33.98±11.43）, （20.98±10.01）, （29.89±3.04） Gy], the differences were statistically significant （P 〈 0.05）. Occurrence rate of radioactive esophagitis in IMRT group and 3D-CRT group were higher than those in CRT group （P 〈 0.05）, occurrence rate of radioactive pneumonitis and ra- dioactive tracheitis in IMRT group and 3D-CRT group were lower than those in CRT group, the differences were sta- tistically significant （P 〈 0.05）. Occurrenee rate of leukocytopenia in IMRT group and 3D-CRT group were lower than those in CRT group, occurrence rate of non-leukocytopenia in IMRT group and 3D-CRT group were higher than those in CRT group, the differences were statistically significant （P 〈 0.01）. Conclusion All the 3 kinds of radiation methods can cure the target area, but IMRT and 3D-CRT have lower harm to the nearby normal tissue than conven- tional radiotherapy, and have fewer complications, which is worthy of promotion.