KẾT QUẢ XẠ TRỊ 3D-CRT VÀ VMAT TRONG HOÁ XẠ ĐỒNG THỜI UNG THƯ THỰC QUẢN TẠI BỆNH VIỆN K

Abstract

Objective: Describe some clinical and paraclinical characteristics and evaluate the results of radiaotherapy by 3D-CRT and VMAT techniques in patients with concurrent chemoradiotherapy with esophageal cancer at K hospital. Subjects ad methods: A retrospective and prospective descriptive study on 60 patients undergoing concurrent chemoradiotherapy for esophageal cancer with 3D-CRT and VMAT techniques at K hospital from May 2018 to May 2021. Results: Mean age 54.4 ± 7.0 (43-69). The male/female ratio is 59/1. Swallowing rate 91.7%. There are 46 (76.7%) patients at T3 stage, 14 (23.3%) patients at T4 stage. The histopathology of the patients was squamous cell carcinoma (100%). Parameters of dose coverage to PTV (planning target volume) of VMAT radiotherapy compared with 3D-CRT: V95: 98.4% - 94.35%, V110: 0.15%-5,35%. Dmax at marrow and skin VMAT is lower than 3D-CRT. The dose in the lungs (V5,V20) and at the heart (V40) of VMAT was lower than that of 3D-CRT. The overall response rate after chemotherapy and radiotherapy was 48.3%, the partial response rate was 41.7%, the disease rate remained unchanged at 10%. Hematologic toxicity was leukopenia (6%), thrombocytopenia (1.7%). Radiation-induced dermatitis (58.4%), radiation-induced esophagitis (18.3%), radiation-induced pneumonia toxicity (3.3%), no cardiovascular toxicity was noted. Conclusion: Radiation therapy for esophageal cancer by VMAT and 3D-CRT techniques gives good and safe results, the VMAT technique shows better radiation dose concentration and less toxicity than 3D-CRT technique.