食道癌腔内放射治疗同时腔内加温的治疗疗效

Therapeutic effects of simultaneous intraluminal irradiation and hyperthermia on esophageal carcinoma

目的 对于晚期食道癌腔内放射及腔内加温同时进行 ,并对其临床意义和疗效进行分析。方法 本文总结了在 1995年 1月至 1998年 9月中 ,8例非手术的食道癌 ,其中 6例接受了 40Gy外放射同时给予了腔内加温和腔内放射 (4Gy ,1次 /周 ,3次 ) ,加温由通用的射频执行。加温治疗仪是内射频加温 10 0 -A ,由欧林巴斯公司生产 ,输出量 3 0分钟 ,提高食道粘膜表面温度 42～ 43℃ ;腔内放射由微小源在加温后 15分钟执行 ,达粘膜下 5mm。结果 4例获得CR ;4例获得局部控制PR。 3例死于局部复发。除 1例漏管外 ,其它没有明显的有害的副作用。结论 腔内放射同时加温的治疗方法 ,在临床上是可以应用。虽然最佳放射剂量有待去探讨 ,但这种方法可以改善对局部晚期食道癌的治疗疗效 ,并且有较好的临床意义。

ObjectiveTo analyse clinical significance and effectiveness of the simultaneous intraluminal radiotherapy and hyperthermia for local advanced esophageal carcinoma.MethodsEight inoperable cases were treated with this method from January 1995 to September 1998. Six cases received 40Gy external irradiation followed by simultaneous intraluminal hyperthermia and radiotherapy(4Gy) once weekly for three weeks. Hyperthermia was delivered by a radio frequency current using thermotherapy instrument (Endoradiotherm 100-A, Olympus Corp.)for 30 min at an output that raised the esophageal mucosa surface temperature to 42 to 43℃. Intraluminal radiotherapy was delivered by Microselectron (Selectron Corp.) to a submucosal depth of 5 mm after the first 15 min of hyperthermia. ResultsFour cases achieved CR (complete response) and four cases achieved local control PR (partial response), and three cases died of local recurrence. No significant adverse side effects except fistula in one case were observed. ConclusionSimultaneous intraluminal irradiation and intraluminal hyperthermia could be applied clinically. Although the optimal radiation dose remains to be determined, this treatment has good therapeutic effects on locally advanced esophageal carcinoma.