放射治疗与动脉插管化疗联合应用治疗晚期贲门癌的疗效观察

目的探讨晚期贲门癌的安全有效的治疗手段。方法对32例晚期贲门癌患者先进行一次经皮穿刺胃左或腹腔动脉的灌注化疗。然后对贲门癌和周围肿瘤病灶进行放射治疗,DT达60 Gy,生物有效剂量（BED）达72 Gy,随访观察患者临床症状改善情况,并对病灶进行X线、胃镜、CT检查和治疗前后对比。结果所有患者临床症状均有明显改善,影像学检查显示,肿瘤病灶明显缩小,患者生存质量提高,生存时间明显延长。结论动脉插管化疗和放射治疗联合应用治疗晚期贲门癌安全,疗效好,副作用小;动脉插管化疗与放射治疗间隔时间越短,疗效越佳,但全身毒副反应也越大;采取三维适形放疗精度高,并发症少,放射治疗增益比提高,从而能更好地提高晚期贲门癌的治疗效果。

Observation on efficacy of radiotherapy combined with transcatheter arterial chemotherapy in treatment of advanced cardiac cancer

Objective To explore safe and effective curative method for advanced cardiac cancer. Methods Thirty-two patients suffering from advanced cardiac cancer were first treated with transcatheter coeliac artery infusion chemotherapy or left gastric artery infusion chemotherapy, then treated with radiation with total radiation dose of 60 Gy/30times and biologically effective dose （BED） of 72 Gy. After treatment, the changes of clinical symptoms of patient were followed-up and observed. The size of tumour was measured by X-ray, gastroscopy and computed tomography （CT） and compared with that before treatment. Results There was obvious improvement of clinical symptoms after treatment in all patients, iconographic examination showed that the volume of tumour was obviously reduced, life quality of patients obviously improved, survival time of patients was obviously prolonged. Conclusion Combined treatment with radiation therapy and transcatheter arterial chemotherapy for advanced cardiac cancer is safe and effective, and has few complications. The shorter the time between transcatheter arterial chemotherapy and radiation therapy, the better the curative effect, but the systemic toxic side effect is more serious. The three-dimensional conformal radiation therapy has high accuracy, few side effect and increased therapeutic gain factor, so appheation of three-dimensional conformal radiation therapy can raise further curative effect on advanced cardiac cancer.