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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 investigate the clinical value of external irradiation combined with high dose rate intraluminal radiotherapy for esophageal cancer. Methods: A retrospective analysis of 398 patients with esophageal cancer treated with high-dose-rate external doses from March 1990 to December 1996 was performed. Controlled studies were performed with 220 patients with esophageal cancer alone during the same period. The external radiation dose was 60 Gy. The single dose for endovascular treatment is 5-8 Gy, 2 or 3 times. RESULTS: 1 The 1-, 3-, and 5-year survival rates of external esophageal cancer treated with external irradiation and afterloading were 64%, 38%, and 21%, respectively, which were higher than the 1-, 3-, and 5-year survival rates of external irradiation alone (53.18). %,21.81%,16.36%),1,3-year survival rate difference was significant(P<0.05);2The difference of 1-,3-,5-year survival rate of intracavitary therapy before and after external irradiation The incidence of complications such as radiation esophagitis increased after intraluminal therapy.4 The incidence of complications was related to the single dose of intraluminal therapy. The complication rate of single dose of 8Gy was significantly higher than that of 5Gy. Conclusion: High-dose-rate intraluminal radiotherapy combined with external radiation therapy for esophageal cancer can improve the survival rate of patients. One of the reasons is that the local control rate is increased, but complications increase. The indications of intraluminal radiotherapy for esophageal cancer should be strictly selected, and the single dose and the number of irradiations should be controlled to ensure the patient’s quality of life.