外照射结合^(252)锎腔内照射治疗中晚期食管癌的远期疗效

Long term observation of external-beam irradiation combined with Cf-252 intracavitary radiation in the treatment of advanced esophageal carcinoma

目的观察外照射结合252锎中子射线内照射治疗中晚期食管癌的远期疗效及不良反应。方法对50例局部中晚期食管癌初治患者先予以常规外照射治疗,外照射采用6-MV X线,2戈瑞/次,1次/日,5次/周,外照射先给予40 Gy,之后予以内外照射同期进行,每周六行内照射治疗一次,内照射每次给予4 Gy,1次/周,共12戈瑞/3次,外照射总量为50 Gy。结果 1、3、5年局控率分别为75.47%、52.0%、45.06%,中位局控时间为45个月;1、3、5年生存率分别为78.0%、42.0%、28.0%,中位生存时间为28个月。晚期放射性食管反应发生率为64%。结论外照射加252锎中子射线内照射治疗中晚期食管癌远期疗效较理想,临床有一定应用前景。

Objective To evaluate long term therapeutic efficacy and the side reaction on external irradiation combined combined with Cf-252 intracavitary radiation in the treatment of advanced esophageal carcinoma.Methods 50 patients with locally advanced esophageal cancer were first treated with conventional external beam therapy,external beam irradiation using 6-MV X-ray,2 Gy/fraction,1 time / day,5 times / week,to a dose of 40 Gy over 4 weeks,then with external and intracavitary radiation concomitantly（4.0 Gy per fraction,once a week to 12 Gy in 3 fractions）,with external irradiation skipped on the day of intracavitary radiation.The total dose of external irradiation was 50 Gy.Results The 1-,3-and 5-year local control rate were 75.47%.52.0%、45.06%,the median local control of time was 45 months.The 1-,3-and 5-year survival rates were 78.0%、42.0%、28.0%,the median survival time was 28 months.The late esophagitis rate was 64%.Conclusion External irradiation combined with Cf-252 neutron ray irradiation in the treatment of advanced esophageal cancer have a better long term results,the clinical application is promising.