论文部分内容阅读
目的 了解常规外照射加腔内放射治疗食管癌的远期疗效、放射反应及并发症。 方法 92例食管癌患者 ,其中单纯放射治疗 (A组 ) 4 7例、外照射加腔内照射 (B组 ) 4 5例 ;外照射剂量10 0Gy/周 ,6～ 7周 ;腔内放射治疗每次 5 0～ 8 0Gy、共 1～ 3次。 结果 放射治疗结束时两组局部控制率差异无显著性意义 (P >0 0 5 ) ;局部复发率A组为 42 6 %、B组为 2 0 %,差异有显著性意义 (P<0 0 5 )。A组和B组 1、3、5年生存率分别为 5 9 6 %、2 5 6 %、10 6 %和 80 0 %、46 7%、2 6 7%;两组差异有显著性意义 (P <0 0 5 )。急性放射反应及并发症的发生与腔内放射治疗有关 ,常见为食管大出血、气管食管瘘、食管穿孔和食管狭窄。本组死亡 6 6例 ,失随访 9例 ,随访率为 90 2 %。 结论 外照射加腔内放射治疗食管癌 ,可降低局部复发率、提高远期生存率 ,但放射治疗反应与并发症发生率明显高于单纯放射治疗组。
Objective To understand the long-term curative effect, radiological response and complications of conventional external radiation plus intracavity radiotherapy for esophageal cancer. Methods A total of 92 patients with esophageal cancer were treated with radiotherapy (Group A) (47 cases) and external irradiation plus intracavity irradiation (Group B) (45 cases). The dose of external irradiation was 100 Gy/week for 6 to 7 weeks. Each time 50 to 80 Gy, a total of 1 to 3 times. Results There was no significant difference in local control rate between the two groups at the end of radiotherapy (P > 0.05). The local recurrence rate was 42.6% in group A and 20% in group B. The difference was significant (P < 0 0 5). The 1-, 3-, and 5-year survival rates in groups A and B were 959%, 256%, 106%, and 800%, 467%, and 267% respectively; there was a significant difference between the two groups ( P <0 0 5 ). The occurrence of acute radiation reactions and complications is related to endoluminal radiotherapy. Common esophageal hemorrhages, tracheo-esophageal fistulas, esophageal perforation, and esophageal strictures are common. Sixty-six patients died in this group, 9 patients were followed up, and the follow-up rate was 90 2%. Conclusion External irradiation plus intracavity radiotherapy for esophageal cancer can reduce the local recurrence rate and increase the long-term survival rate. However, the radiotherapy response and complication rate are significantly higher than that of radiotherapy alone.