60例高龄食管癌放射治疗分析

目的研究高龄食管癌患者放射治疗的特点。方法在积极对症,支持治疗的同时,对60例年龄在85-92岁之间的高龄食管癌患者以小照射野、低剂量进行常规放射治疗或适形精确放疗,放疗过程中经常进行食管造影、心肺功能检查。结果59例高龄食管癌患者安全地完成了放射治疗,未出现严重并发症,生存质量明显提高,生存时间明显延长,其中适形精确放疗效果更好,副作用更少。1例溃疡型食管癌患者疗程结束时出现食管穿孔,经食管支架植入后现已存活2年。结论高龄食管癌患者发现晚,病情严重,心、肺功能及全身状况差,放射治疗风险大,但在积极对症、支持治疗的同时,进行放射治疗是有意义的,不能追求大而全,包及所有肿瘤病灶的照射野,不能追求高剂量、高疗效,应经常进行检查,及时处理可能出现的并发症。

Study on radiation therapy of 60 esophagus carcinoma patients of advanced age

Objective To study the characteristics of radiation therapy of esophagus carcinoma patient of advanced age.Methods Sixty esophagus carcinoma patients aged 85-92 years were treated with routine or conformal precise radiotherapy of small irradiation field and low dose.At the same time,symptomatic treatment and nourishment were given.Esophagus radiography and the examination of heart and lung function were often performed in the course of radiotherapy.Results Fifty-nine patients of advanced age suffering from esophagus carcinoma underwent radiation therapy safely. There was no serious complication, life quality was improved obviously, life time was prolonged obviously. Between the two radiotherapy methods, three-dimensional conformal radiotherapy was more effective and the complication was less. One esophagus carcinoma patient of ulcer type got a perforation in his esophagus when he was going to finish radiotherapy, he has lived for two years after implanting esophagus stent. Conclusion The esophagus carcinoma in patients of advanced age is found late, the illness is always serious and the patients＇ heart and lung function and general condition are poor, although there is danger in the course of radiotherapy, yet radiotherapy is of value, in the meantime, symptomatic treatment and nourishment can be given. The irradiation field to include all tumor foci and high dose and high curative effect must not be pursued, examination must be per- formed frequently in order to deal with possible complication in time.