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目的探讨全程伽玛刀治疗食管癌的最佳治疗模式。方法将76例条件相似的中上段食管癌患者分为3组:A组19例,全程经典伽玛刀治疗模式,60%～70%的剂量线包括靶区,3.5～4.5 Gy/次,3次/周,共10～12次;B组29例,先给予直线加速器普通次放疗38～40 Gy/19～20次,再给予伽玛刀经典治疗局部肿瘤加量,3.5～4.0 Gy/次,共4～5次;C组28例,全程伽玛刀治疗,采用密集均匀布靶法,每周更换计划1次,采用65%～70%的剂量线为参考剂量线,每次周边2 Gy,5次/周,共20～22次。结果 3组近期疗效差异无统计学意义(P>0.05)。B、C组1年生存率均高于A组,Ⅲ～Ⅳ级放射性食管发生率均低于A组,差异有统计学意义(P<0.005)。结论伽玛刀采用密集均匀布靶法,每次小剂量,每周更换计划的模式为治疗食管癌较好的治疗模式。
Objective To explore the best treatment model of esophageal cancer with gamma knife. Methods A total of 76 patients with similar esophageal cancer were divided into three groups: group A (n = 19), full-dose classic gamma knife treatment and dose range of 60% ~ 70%, including target area, 3.5-4.5 Gy / Once a week for a total of 10 to 12 times. In group B, 29 patients were given radiotherapy for general linear radiotherapy at 38 to 40 Gy / 19 to 20 times. The local tumor volume was 3.5 to 4.0 Gy / time , A total of 4 to 5 times; C group of 28 patients, full gamma knife treatment, the use of dense uniform Targeting method, a weekly replacement plan, using 65% to 70% of the dose line as the reference dose line, each peripheral 2 Gy, 5 times / week, a total of 20 to 22 times. Results There was no significant difference in short-term efficacy between the three groups (P> 0.05). The 1-year survival rates of group B and C were higher than that of group A, and the incidence of stage Ⅲ-Ⅳ radioactive esophageal tumors was lower than that of group A, the difference was statistically significant (P <0.005). Conclusion Gamma knife using dense uniform target method, each small dose, weekly replacement plan for the treatment of esophageal cancer is a better treatment model.