溃疡型和并发穿孔的食管癌置鼻饲管后放射治疗的临床观察

EFFECT OF INSERTING NASOGASTRIC TUBE DURING RADIOTHERAPY FOR ULCERATING OR FISTULIZED ESOPHAGEAL CARCINOMA

溃疡型和并发穿孔食管癌 4 1例 ,其中溃疡型 2 1例 ,食管癌并穿孔 2 0例。置鼻饲管饮食后 ,采用60 Co体外常规放射治疗 ,肿瘤量为 6 0～ 6 5Gy/6～ 6 .5周。放疗后食管壁小溃疡 1例完全愈合 ;中溃疡 1 0 /1 3例完全愈合 ,2 /1 3例基本愈合 ;大溃疡 2 /7例完全愈合 ,3/7例基本愈合 ;食管 -纵隔瘘 3/1 0例完全愈合 ,5 /1 0例基本愈合 ;食管 -气管、支气管瘘 1 /1 0例完全愈合 ,4 /1 0例基本愈合。总有效率为 75 .6 %。 1 ,2年生存率 ,溃疡型分别为 4 2 .8%和 2 6 .6 % ,食管癌并穿孔分别为 2 5 .0 %和 1 0 .0 %。

From 1990 to 1992, 41 patients with ulcerating or fistulized esophageal carcinoma (EC) were treated by the conventional irradiaton after a nasogastric tube was inserted into the esophageal lumen. The total doses were 60～65GY/6～6.5WKS. The results were: 1/1 CR in patients with small ulcer, 10/13 CR and 2/13 PR in patients with medium-sized ulcer, 2/7 CR and 3/7 PR in patients with large ulcer, 3/10 CR and 5/10 PR in patients with esophageal mediastinal fistula and 1/10 CR and 4/10 PR in patients with esophagel tracheal or bronchial fistula. The total remission rate was 75.6%(31/41). The 1-and 2-year survival rates were 42.8%, 26.6% for EC with ulcer and 25%, 10% for EC with fistula, respectively.