摘要
目的 :近年食管癌的腔内放疗应用逐渐增多 ,局部控制率稍有改善 ,但并发症也明显增多 ,有必要深入地了解这些并发症的具体情况。材料与方法 :1 993年 8月至 1 994年 5月 3 8例食管癌病人在我院接受内、外结合照射 (资料完整者 ) ,男 2 3例 ,女 1 5例。用 4MV -X线常规外照射 3 80 0cGy/ 1 9次后 ,开始内外照射同期进行 ,腔内照射参考点为距源中心轴 1 0mm处 ,5 0 0cGy/次 /周 (当日停外照射 ) ,腔内照射范围为外照射前食管病变上下端分别外放 1 .5cm ,结束时外照射总剂量 5 0 0 0cGy/ 2 5F/ 5W ,腔内照射总剂量为 1 5 0 0cGy/ 3F/ 3W。 结果 :(1 )食管炎的发生率为 68.4% (2 6/ 3 8) ,多在第 2次腔内照射后出现。 (2 ) 2 5例狭窄与其形成的因素 :治疗前肿瘤长度 ,病变周围软组织阴影 ,食管炎 ,腔内照射前管腔直径及管壁硬度。 (3 ) 1 0例溃疡者腔内照射剂量均为 1 5 0 0cGy/ 3次 / 3周 ,且均有明显的食管炎 ,其中7例先后出现狭窄和溃疡。 (4 ) 6例发生食管瘘 ,仅 1例 (5 0 0cGy)疗中出现 ,余 5例腔内照射剂量均为1 5 0 0cGy/ 3次 / 3周 ,且均在 6个月后出现。 结论 :食管癌腔内照射近期缓解效果明显 ,可以改善进食 ,对长期生存的影响尚未肯定 ,疗后严重并发症明显增多 ,影响生存质量 ,我们认为它只能是?
Purpose: At present ,the local control of esophageal carcinoma have been improved by using intra-cavitary irradiation, but the complications a much more than before. It is necessary to study the real condition of these complications.Materials and Methods: From August 1993 to May 1994,38 patients with esophageal carcinoma were treated with external beam combined with intra-cavitary radiotherapy in our hospital. Conventional radiotherapy was used 200cGy/F,5F/W.When the dose of external beam reached 3800cGy/19F,intra-cavitary radiotherapy was added with the dose of 500cGy/F/W(patient did not receive the external beam at the same day). The total dose of external and intra-cavitary radiotherapy were 5000cGy/25F/5W and 1500cGy/3F/3W at end of the course respectively.Results: ① 68.4%(26/38) patients had esophagitis.②25 patients suffered from the non-carcinoma esophagostenosis, which was related to the length of tumor before treatment, the shade of soft tissue around lesion, the esophagitis, the diameter of esophagus cavitary and stiff of esophagus wall before intracavitary radiotherapy.③10 of 38 cases had non-carcimoma ulcer. All patients had received 1500cGy/3F/3W intracavitary radiotherapy and occured serious esophagitis, 7 of 10 suffered from the non-carcinoma stricture and ulcer before or later.④ 6 of 38 cases had the fistula and 5 patients had been exposed 1500cGy/3F/3W intracavitary radiotherapy.Conclusion: Esophageal carcinoma treated by afterloading techniques may improve the serious obstruction immediately, but it is not sure the long-term survial yet. We also find the increasing serious complications and the decreasing life quality by using this treatment.We suggests that this method only can be used as an auxilliary way with the external beam radiotherapy.
出处
《中华放射肿瘤学杂志》
CSCD
1996年第2期15-17,共3页
Chinese Journal of Radiation Oncology
关键词
食管癌
腔内放疗
并发症
Esophageal carcinoma Intra-cavitary radiotherapy
