~(60)Co常规分割放射治疗食管癌376例远期疗效分析

目的 :回顾分析 6 0 Co常规分割放射治疗食管癌远期疗效及其预后因素。方法 :从 1990年 12月到 1994年 3月 ,应用 6 0Co常规分割放射治疗食管癌 376例 ,Dt6 8- 72 Gy。平均年龄 6 2 .4岁 ,鳞癌 98.4% ,其中髓质型 2 2 3例 ,蕈伞型 13例 ,溃疡型44例 ,缩窄型 6 2例 ,腔内型 2 3例 ;病变长度≤ 5 cm5 7例 ,5 .1～ 7cm2 0 2例 ,>7cm117例。结果 :全组 1、2、3、5年生存率分别为 5 4.2 6 %、34 .84%、18.6 1%和 8.2 4%。其中蕈伞型预后最好 ,髓质型次之 ,溃疡型最差 ,其差异有非常显著意义 (P<0 .0 1) ;病变长度越长 ,预后越差 ,其差异有显著意义 (P<0 .0 5 ) ;病变部位越高 ,预后越好 ,但差异无显著意义 (P<0 .0 5 )。结论 :6 0 Co常规分割放射治疗食管癌副反应较小 ,多数病人可以耐受 ,但远期疗效较差。因此 ,应根据 X线分型 ,病变长度和病变部位等因素选择不同的治疗方式。

Long term treatmentanalysis on the3 76cases of esophageal carcinoma treatmentby~(60) Co conventional fraction radiotherapy

Objective:To review and analyze long term treatmenteffectand prognostic factors ofesophageal carcinoma treatment with conventional fraction radiotherapy.Methods:From December of 1 990 to March of1 994,376cases of esophageal carcinoma had been treated with60 Co conventinal fraction radiotherapy,Dt was 68— 72 Gy,the average age was 62 .4.There were 98.4% of squamous cell carcinoma.Of which there were2 2 3cases of marrow type,1 3cases of gill type;44cases of ulceration type;62 cases of stenotic type and 2 3cases of intracavity type.the lesion length≤ 5cm for 57cases,5.1～ 7cm for 2 0 2 cases ,>7cm for 1 1 7cases.Results:The survival rate atl year,2 year,3yearand5years was54.2 6% ,34.84% ,1 8.61 % and 8.2 4 % .Among all the cases,the prognosis of gill type was better than others,marrow type is next,the ulceration is worst,the discrapancy between them shows greatsignificance ( P<0 .0 1 ) the longer the lesion length is,the worst the prognosis would be,the discrepancy has great significance( P<0 .0 5) ;the higher the lesion is positioned,the better the survival would be,but no greatsignificance( P>0 .0 5) .Conclusions: The long term treatment effect is not good enough while adopting60 Co conventional fraction radiotherapy to deal with esophageal carcinoma,therefore,the different treatmentshould be chosen according to type of X ray,length of lesion and the position of lesion as well as other factors.