Changes Of Serum Myocardial Enzyme For Patients With3D Conformal Radiotherapy Of Esophageal Carcinoma

Objective: To compare the serum myocardial enzyme spectrum, electrocardiogram before radiotherapyand in the treatment dose with40Gy and60Gy in the middle and lower segment esophagus cancerpatients.The use of dose-volume histogram control heart irradiated volume and dose, combing withclinical and electrocardiographic manifestations to explore serum enzymes and ECG monitoring of cardiacinjury in clinical applications in three-dimensional conformal radiotherapy of esophageal cancer, and toexplore the correlation among the control of esophageal cancer therapeutic dose cause early heart damageand cardiac irradiation dose and volume irradiated.Methods: Thirty patients were accepted for the first time in our department for three-dimensionalconformal radiotherapy for the middle and lower segment esophagus cancer during the period May2010toJuly2013. Strict selection criteria in all patients were the pathological diagnosis clear, no previous historyof coronary artery disease, normal ECG, no damage to the immune function in acute and chronic illnesses,there is no recent history of infection, no chemotherapy before radiotherapy. Among them, Therewere22cases in male patients and8cases in female patients. Aged from54to88years, mean71years.radiotherapy simulator machine were used for body membrane production, CT scans positionedtransmitting image data to the TPS on the three-dimensional conformal radiotherapy planning, based on areasonable choice of the patient’s body fat with6MV or10MV linear accelerator energy X-ray irradiation,the prescribed dose was suggested higher than60Gy in the tumor, a single dose of2Gy/f,5f/w, thetreatment time of6-7weeks. all patients were check serum enzymes and ECG in the period beforeradiotherapy and when radiation dose to40Gy and60Gy using automatic biochemical analyzer ROCHEMODULAR DPP for determination of serum enzyme. through observing the changes in serum enzymesand ECG, The use of dose-volume histogram prescription dose40Gy judge the heart, the heart of30%and60%of the volume receiving radiation dose.Results: There are no significant difference in serum myocardial enzyme spectrum andelectrocardiogram among before radiotherapy, radiotherapy to40Gy group and radiotherapy to60Gy group.one case of ST-T changes down, one case of Occasional room premature beat in treatment dose40Gy;another case of Occasional room premature beat in treatment dose60Gy, the patient take initiative to giveup treatment. For radiation safety, the serum enzyme and ECG of the patients are normal after treatment ofthe auxiliary dilate coronary, and the remaining patients continued to complete the scheduled radiotherapy.Conclusion:1. The dynamic monitoring of serum enzymes and ECG changes could help clinicians adjusttreatment strategy and has important clinical significance to increase radiation safety in Esophagealdimensional conformal radiotherapy;2.Dimensional conformal radiotherapy could reduce heart damage,maximum control tumors, improving the quality of life of patients with high therapeutic ratio in thetreatment of esophageal cancer.