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目的 :回顾分析 6 0 Co常规分割放射治疗食管癌远期疗效及其预后因素。方法 :从 1990年 12月到 1994年 3月 ,应用 6 0Co常规分割放射治疗食管癌 376例 ,Dt6 8- 72 Gy。平均年龄 6 2 .4岁 ,鳞癌 98.4% ,其中髓质型 2 2 3例 ,蕈伞型 13例 ,溃疡型44例 ,缩窄型 6 2例 ,腔内型 2 3例 ;病变长度≤ 5 cm5 7例 ,5 .1～ 7cm2 0 2例 ,>7cm117例。结果 :全组 1、2、3、5年生存率分别为 5 4.2 6 %、34 .84%、18.6 1%和 8.2 4%。其中蕈伞型预后最好 ,髓质型次之 ,溃疡型最差 ,其差异有非常显著意义 (P<0 .0 1) ;病变长度越长 ,预后越差 ,其差异有显著意义 (P<0 .0 5 ) ;病变部位越高 ,预后越好 ,但差异无显著意义 (P<0 .0 5 )。结论 :6 0 Co常规分割放射治疗食管癌副反应较小 ,多数病人可以耐受 ,但远期疗效较差。因此 ,应根据 X线分型 ,病变长度和病变部位等因素选择不同的治疗方式。
Objective : To retrospectively analyze the long-term curative effect and prognostic factors of 6 0 Co conventional segmentation radiotherapy for esophageal cancer. METHODS: From December 1990 to March 1994, 376 patients with esophageal cancer were treated with conventional fractionation of 60Co, Dt6 8-72 Gy. The mean age was 62.4%, and the squamous cell carcinoma was 98.4%, including 232 cases of medullary type, 13 cases of sputum umbrella type, 44 cases of ulcer type, 62 cases of constricted type, 23 cases of intraluminal type. Lesion length≤ 5 cm5 7 cases, 5-1 ~ 7cm2 0 2 cases,> 7cm 117 cases. Results: The overall 1, 2, 3, and 5-year survival rates were 54.26%, 34.84%, 18.61%, and 8.24%, respectively. Among them, the parachute type had the best prognosis, the medulla type was the second, and the ulcer type was the worst, the difference was very significant (P<0.01); the longer the lesion length, the worse the prognosis, and the difference was significant (P). <0. 0 5); The higher the lesion location, the better the prognosis, but the difference was not significant (P <0. 05). Conclusion : The conventional fractionated radiotherapy with 60 Co has a minor side effect on esophageal cancer. Most patients can tolerate it, but the long-term efficacy is poor. Therefore, different treatment methods should be selected according to factors such as X-ray type, lesion length and lesion location.