食管癌伴声带麻痹53例临床及放疗疗效分析

The therapeutic analysis of radiotherapy of esophageal cancer with paratysis of vocal ligament:a report of 53 cases

目的探讨伴有声带麻痹的食管癌最佳的治疗手段和影响愈后的因素.方法 对1983年～1992年本院放疗科初治并经病理证实伴声带麻痹的53例食管癌进行了回顾性分析.治疗方式:单纯根治放疗21例;单纯姑息放疗9例;根治放疗+化疗10例;姑息放疗+化疗13例.结果 53例伴有声带麻痹的食管癌患者疗前声嘶时间越短其声嘶改善机会越多,声嘶改善效果越明显.中位生存期11月,1年生存率43.4%、3年生存率11.3%、5年生存率3.8%,6例存活3年以上患者均经CT确定靶区,模拟定位机定位.结论 根据CT等现有诊断手段,可以精确确定病变部位及侵犯范围,模拟定位机能更精确地定位病变器官,避开正常组织从而使病变组织受到较高的根治剂量(55～70Gy),有望得到较好疗效.

[Abstract] Objective To study the effect of therapeutic factors to prognosis for esophageal cancer with paralysis of vocal ligament .Methods The relationship between therapeutic factors and prognosis were analyzed retrospectively for 53 cases of esophageal cancer with paralysis of vocal ligament treated from 1983 to 1992 in our hospital.opathological diagnosis was squmous cell esophageal carcinoma.Radiotherapy or (and) chemotherapy was given the patients after diagnosis,radical irradiation for 21 cases.Palliative irradiation for 9 cases,radical irradiation + chemotherapy for 10 cases, palliative irradiation + chemotherapy for 13 cases.Results The overall 1-., 3-, 5-year survival rates were 43.3%., 11.3%, 3.8%.The median survival time was 11 months.Six patients still survived for three years. Their radiation fields covered the primary tumor mediastinum,supraclavicular region. Early visits enable the patients to received good results in improved hoarseness of the voice.Conclusions The 1-,3- year survival rates patients with esophageal carcinoma with paralysis of vocal ligament can be improved by applied CT scan and simn-lator.The accurate location of tumor should be determind accoding to the CT scan and simulator.