外照射加锎-252中子腔内照射治疗70例食管癌

External irradiation combined with californium-252 neutron intraluminal brachytherapy for treatment of 70 cases with esophageal carcinoma

目的:观察外照射加锎-252(252Cf)中子腔内照射治疗食管癌的疗效.方法:70例食管癌患者每周接受一次252Cf中子腔内照射,4 Gy/次,总剂量16 Gy/4周;中子治疗开始后第二天接受60Co外照射,4次/周,总剂量50～56Gy.结果:①近期疗效:CR 87.1%,PR 11.5%,NR 1.4%;②1年生存率75.7%,2年生存率51.4%,3年生存率22.9%;③并发症发生率:放射性食管炎48.6%,食管溃疡7.1%,食管狭窄25.7%,食管瘘2.9%.结论:外照射加252Cf中子腔内照射治疗食管癌的近期疗效及1年、3年生存率与外照射结合192Ir腔内放疗相近,可能具有一定的应用前景.

Purpose：To observe the curative effects of external irradiation （EI） combied with californium-252（^252 Cf）neutron intraluminal brachytherapy（IBT）for treatment of esophageal carcinoma.Methods：70 esophageal careinoma patients were treated with ^252Cf neutron IBT once a week,4 Gy/fraetion,the total dose of IBT was 16Gy/4 weeks.From the second day after ^252Cf neutron IBT,^60 Co EI was delivered at 2Gy per fraction,4 times per week,the total dose of EI was 50-55Gy.Results：①The sbort-term curative effects showed that CR was 87.1%,PR was 11.5%,NR was 1.4%;②The 1-,2-and 3-year survival rates were 75.7%,51.4% and 22.9% respectively;③The incidence of irradiation complications,including esophagitis,esophageal ulcer.esophageal stricture and esophageal fistula was 48.6%,7.1%,25.7% and 2.9% respectively.Conclusions：EI combined with ^252Cf neutron IBT for treatment of esophageal carcinoma has the same short-term curative effects and 1-,3-year survival rates as EI combined with ^192Ir IBT.This method perhaps has good prospects to use.