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目的通过化、放续贯治疗手段解决完全梗阻性食管癌进食梗阻症状,完成放射治疗。提高局部控制率,延长生存期。方法回顾分析1999年4月~2003年10月本院收治完全梗阻性食管癌21例,占全部放射治疗食管癌病例2.4%,这21例完全梗阻性食管癌均为胸段食管癌,完全不能进食时间3~10天。分为两组10例单纯放疗组,11例为化、放疗续贯治疗组。10例单纯放疗采用常规分割放疗。每次180~200cGy/F,每周5次。另11例采用先化疗,“DF”方案8例,“NP”方案3例,在化疗后12~18天进行放射治疗。放疗为常规分割放疗。分割剂量、方法同单纯放疗组。结果10例单纯放疗组有9例在放疗开始后1~4周,因进食梗阻症状不能改善终止放疗。有1例放疗6周,10例均不能改善进食症状。分别在接受放疗后1~2个月内死亡。中位生存期40天。另11例化疗、放疗综合治疗组在化疗后1~7天,11例均能改善进食梗阻。除1例在化疗后第3周因全身情况差未完成放疗,余10例均完成放疗。放疗期和放疗后全身情况相对差。血液性毒性相对大,中位生存期14个月。两组治疗有显著性差异。P<0.0001。结论完全梗阻性食管癌单纯放疗疗效不佳。用先化疗缓解进食梗阻症状效果好。再通过放射治疗控制肿瘤生长,提高局部控制率,延长生存期。
Objective To resolve the symptoms of complete obstructive esophageal feeding obstruction by means of continuous and continuous treatment, and complete the radiotherapy. Improve local control rate and prolong survival. Methods Retrospective analysis from April 1999 to October 2003 in our hospital 21 cases of complete obstruction of esophageal cancer, accounting for 2.4% of all radiation treatment of esophageal cancer cases, these 21 cases of complete obstruction of esophageal cancer are thoracic esophageal cancer, can not Eating time 3 to 10 days. Divided into two groups of 10 cases of radiotherapy alone, 11 cases of chemotherapy, radiotherapy continued treatment group. Ten cases of simple radiotherapy using conventional radiotherapy. Each 180 ~ 200cGy / F, 5 times a week. The other 11 cases were treated with the first chemotherapy, 8 cases were “DF” and 3 cases were “NP”. Radiotherapy was performed 12 to 18 days after chemotherapy. Radiotherapy for conventional radiotherapy. Divide the dose, the same method with a simple radiotherapy group. Results In 10 patients with radiotherapy alone, 9 patients were discontinued after radiotherapy for 1 to 4 weeks. One case of radiotherapy for 6 weeks, 10 cases can not improve eating symptoms. Respectively, after receiving radiotherapy within 1 to 2 months of death. The median survival period of 40 days. Another 11 cases of chemotherapy, radiotherapy combined treatment group 1 to 7 days after chemotherapy, 11 patients can improve eating obstruction. In addition to 1 case in the third week after chemotherapy due to poor general condition did not complete radiotherapy, the remaining 10 cases were completed radiotherapy. Radiotherapy and systemic conditions after radiotherapy is relatively poor. Relatively large blood toxicity, the median survival of 14 months. There was a significant difference between the two groups. P <0.0001. Conclusions Complete obstructive esophageal cancer alone radiotherapy ineffective. With the first chemotherapy to ease the symptoms of obstruction is good. Then through radiation therapy to control tumor growth, improve the local control rate, prolong survival.