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目的 探讨影响食管癌放射治疗疗效的相关因素及其合理治疗方法。方法 对 6 4例根治性放射治疗后局部复发或未控制再行根治性手术者 (根治组 )与 11例术前放疗 (术前组 )食管癌患者的手术标本进行病理检查 ,着重对组织形态学进行对比分析 ,依其发生放疗反应的程度推测肿瘤对放射线的敏感性。结果 75例标本中 ,病理切片HE染色表现出放疗反应者共 32例 (4 2 .7% ) ,其中根治组 2 7例 (4 2 .2 % ) ,术前组 5例 (4 5 .5 % )。根治组发生轻度放疗反应 7例 ,中度放疗反应 12例 ,重度放疗反应 8例。术前组发生轻、中、重度放疗反应分别为 0例、3例和 2例。结论 肿瘤的浸润深度和病理类型是决定肿瘤对放射线敏感性的最直接因素。单纯增加放射剂量不能提高肿瘤的治愈率。放疗过程中半根治量时可以进行X线片及活检病理切片检查 ,以了解患者对放射线的敏感性 ;对于无放疗反应的患者可改用手术治疗。
Objective To explore the factors that affect the efficacy of radiotherapy for esophageal cancer and its reasonable treatment. Methods Sixty-four patients with locally recurrent or uncontrolled radical mastectomy (radical group) and 11 patients with preoperative radiotherapy (preoperative group) of esophageal cancer underwent pathological examination. Study conducted comparative analysis, according to the degree of occurrence of radiotherapy response tumor radiosensitivity. Results Of the 75 specimens, there were 32 cases (42.7%) with pathological examination by HE staining, including 27 cases (42.2%) in the radical group and 5 cases (5.5%) in the preoperative group %). Radical group had 7 cases of mild radiotherapy reaction, 12 cases of moderate radiotherapy and 8 cases of severe radiotherapy. Preoperative group of mild, moderate and severe radiotherapy reactions were 0 cases, 3 cases and 2 cases. Conclusion The depth of tumor invasion and pathological type are the most direct factors that determine the sensitivity of tumor to radiation. Simply increasing the radiation dose can not improve the cure rate of the tumor. Radiotherapy during the half-dose can be X-ray and biopsy biopsy to understand the patient’s sensitivity to radiation; for patients without radiotherapy may use surgery.