外照射结合252锎腔内照射治疗中晚期食管癌的远期疗效

医学研究与教育 ›› 2012, Vol. 29 ›› Issue (6): 25-27.

外照射结合252锎腔内照射治疗中晚期食管癌的远期疗效

盖晓惠¹,崔桂敏¹,蔺强²,史鸿云¹,李志刚¹,王永强¹,刘惠明³

1.河北大学附属医院,河北保定 071000
2.华北油田总医院,河北任丘 062550
3.山西太行灵顿肿瘤医院,山西长治 046000

收稿日期:2016-10-09 修回日期:2016-10-09 出版日期:2012-12-25 发布日期:2012-12-25

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

Received:2016-10-09 Revised:2016-10-09 Online:2012-12-25 Published:2012-12-25

摘要/Abstract

摘要： 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.

关键词: 食管癌, 放射治疗, 内照射治疗, 252锎, 远期疗效

Abstract: 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.

Key words: esophageal carcinoma, radiotherapy, intracavitary radiation therapy, Cf-252, long term effect

中图分类号:

R735.1

盖晓惠,崔桂敏,蔺强,史鸿云,李志刚,王永强,刘惠明. 外照射结合252锎腔内照射治疗中晚期食管癌的远期疗效[J]. 医学研究与教育, 2012, 29(6): 25-27.

参考文献

[1] 赵环宇, 王科明, 孙坚, 徐慧. 外照射加锎-252中子腔内照射治疗70例食管癌 [J]. 中国癌症杂志 2005.doi:10.3969/j.issn.1007-3639.2005.05.024
[2] 王科明, 赵环宇, 孙坚, 徐慧. 外照射加锎-252中子腔内照射治疗食管癌的临床观察 [J]. 临床肿瘤学杂志 2004.doi:10.3969/j.issn.1009-0460.2004.06.040
[3] 杨杰, 波拉提, 阿衣古丽, 曲宝云, 严为民, 热依拉. 外照射结合252锎(252 Cf)中子近距离治疗恶性肿瘤近期疗效 [J]. 实用肿瘤学杂志 2006.doi:10.3969/j.issn.1002-3070.2006.05.028
[4] 罗刚, 郑成位, 单锦露, 刘佳, 沈英霞. 252 锎中子腔内后装治疗子宫颈癌的临床观察 [J]. 中华妇产科杂志 2001.doi:10.3760/j.issn:0529-567X.2001.12.011
[5] 盖晓惠, 高献书, 刘惠明, 周志国, 张戈妹, 贾喜堂, 万钧. 外照射配合252锎中子射线腔内照射治疗食管癌的临床观察 [J]. 实用癌症杂志 2011.doi:10.3969/j.issn.1001-5930.2011.04.020
[6] 李维贵, 张德洲, 王洪道, 汪海新. 食管癌外照射联合腔内放射治疗临床疗效分析 [J]. 实用医药杂志 2003.doi:10.3969/j.issn.1671-4008.2003.08.020
[7] 乔学英, 周道安, 高献书, 麻国新, 万钧. 常规与后加速超分割及常规加腔内照射治疗食管癌的远期疗效 [J]. 中华放射肿瘤学杂志 2004.doi:10.3760/j.issn:1004-4221.2004.04.004
[8] 常则灵, 尹贞元, 王秀兰. 体外加腔内照射治疗食管癌与单纯外照射的前瞻性随机实验 [J]. 中国放射肿瘤学 1991, 5(01).
[9] SUR R K, SINGH D P, SHANNA S C. Radiation therapy of esophageal cancer:role of high dose rate brachytherapy [J]. International Journal of Radiation Oncology, Biology, Physics 1992, 22(05).
[10] HAREYAMA M, NISHIO M, KAGAMI Y. Intracavitray brachytherapy combined with external beam irradiation for squamou cell carcinoma of the thoracic esophagus [J]. International Journal of Radiation Oncology, Biology, Physics 1992, 24(02).
[11] 高献书. 食管癌非手术分期标准 [A]. 北京:中国医药科技出版社 2011.
[12] 万钧, 肖爱勤, 高淑珍. 食管癌放疗后近期疗效评价标准--附1000例分析 [J]. 中华放射肿瘤学杂志 1989, 3(04).
[13] 于金明. 提高治疗增益比的生物-物理方法 [A]. 济南:山东科学技术出版社 2005.
[14] Akagi Y, Hirokawa Y, Kagemoto M, Matsuura K, Ito A, Fujita K, Kenjo M, Kiriu H, Ito K. [J]. International Journal of Radiation Oncology, Biology, Physics 1999.