摘要
目的：探讨外照射加用高剂量率腔内放射治疗食管癌的临床价值。方法：回顾性分析１９９０年３月至１９９６年１２月间采用了外照射高剂量率后装治疗的食管癌病人３９８例，与同期单纯外照射食管癌病例２２０例进行对照研究，外照射剂量６０Ｇｙ，腔内治疗单次剂量为５～８Ｇｙ，２～３次。结果：①外照射加后装治疗食管癌的１、３、５年生存率分别为６４％、３８％、２１％，高于同期单纯外照射组１、３、５年生存率（５３．１８％、２１．８１％、１６．３６％），１、３年生存率相差显著（Ｐ＜０．０５）；②外照射前或后加用腔内治疗的１、３、５年生存率差异不显著；③加用腔内治疗后放射性食管炎等并发症的发生率增多；④并发症发生与腔内治疗的单次剂量有关，单次剂量为８Ｇｙ比５Ｇｙ的并发症发生率明显增加。结论：高剂量率腔内放疗配合外照射治疗食管癌能提高病人的生存率，原因之一是提高了局部控制率，但并发症增多。应严格选择食管癌腔内放疗的适应症，控制单次剂量及照射次数，确保病人的生存质量。
Objective: To explore the clinical value of external radiotherapy (ERT) combined with high dose rate intraluminal brachytherapy (HDRIBT) in treatment of esophageal cancer. Methods: The data of 398 cases of esophageal cancer treated with ERT combined with HDRIBT from May, 1990 to December, 1996 in our department were retrospectively analyzed and compared with those of 220 cases treated with ERT alone in the same period. The total dose of ERT was 60 Gy and that of HDRIBT was 5～8 Gy in 2～3 fractions in 2～3 weeks. Results: ① The 1 , 3 and 5 year survival rates of the patients treated with ERT combined with HDRIBT were 64%, 38% and 21% whereas those of the patients treated with ERT alone were 53.18%, 21.18% and 16.36% respectively. There was significant difference between the two groups of patients (P<0.05). ② No marked difference of the survival rates was found between the patients received HDRIBT before ERT and those received HDRIBT after ERT. ③ The incidence of complications was higher in patients treated by ERT combined with HDRIBT than in those with ERT alone. ④ The incidence of complications was associated with the dose of HDRIBT. Conclusion: The combination of ERT and HDRIBT can improve the survival rate of the patients with esophageal cancer. Since the incidence of complications is increased, the indications should be strictly selected and irradiating dose and times be controlled to assure the quality of life of the patients.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
1998年第5期433-435,共3页
Journal of Third Military Medical University
关键词
近距离治疗
食管肿瘤
放射疗法
brachytherapy
esophageal cancer
complication
radiotherapy
