胸段食管癌腔内治疗加外照射的经验报道

Intracavitary plus External Irradiation for Thoracic Esophageal Cancer

总结腔内治疗加外照射根治性放疗中晚期胸段食管癌70例的疗效，探寻腔内治疗与外照射较合理剂量搭配。本组病例1年生存率为74．3％，3年25．7％，5年12．5％；同期单纯外照射中晚期食管癌41例的1、3、5年生存率分别为48．8％、17．1％和10．0％。作者认为：1）腔内治疗作为一种辅助治疗手段与外照射结合能提高中晚期食管癌的局部控制率，而对生存率的改善无显著意义。2）适宜的内外照射剂量搭配是提高疗效的关键，对中晚期食管癌较合理搭配剂量为：常规外照射DT60～70Gy／6～7周后改腔内治疗5～10Gy／1～2周。腔内剂量过低不易控制局部病变，剂量过高特别是次量过高易引起食管溃疡甚至穿孔。3）对于胸上段食管癌在进行内外结合治疗的同时，应常规进行双锁骨上区预防性照射。

The therapeutic results of high dose intracavitary radiation plus external irradiation in 70 cases of intermediate and late stage thoracic esophageal cancers were evaluated with stress on optimum dosage. The 1-, 3-, 5-year survival rates of thls group were 74. 3 %, 25. 7 %, 12. 5 % respectively; and those of 41 cases treated in the same period with external irradiation alone were 48. 8%, 17. 1 %,10. 0% respectively. The authors consider: 1) Intracavitary plus external irradiation for intermediate or advanced esophageal cancer is able to improve the local control of the tumor. 2)The appropriate dosage of irradiation is the key for enhancernent oftherapeutic effect and for prevention of complications such as esophageal. ulcer formation and perforation. 3)In cases with upper segment esophageal cancer preventive irradiation of the supraclavicular area should be performed.