晚期食管贲门癌综合治疗的研究

对50例晚期食管贲门癌包括伴有锁骨上淋巴结已有转移的病人,以手术切除为主,术后辅以化疗、放疗行综合性治疗。每例病人用卡铂200mg+5％葡萄糖液500ml静滴,每日1次,3天为一疗程,每月1次×3疗程。有癌残留或附近脏器有癌受侵润,切除不彻底者给予常规放疗,放疗剂量为40～70Gy。手术并发症7例:胸内吻合口瘘1例,颈部吻合口小瘘1例,呼吸衰竭2例,死亡率为4％,原因:1例为吻合口瘘感染导致主动脉破裂大出血,另1例呼吸衰竭死亡。近期随访结果:本组48例,死亡18例,死亡原因绝大多数是远处转移或复发。术后半年内死亡4例,1年内死亡7例,2年内死亡7例,总死亡率40％,2年内近期存活率63.3％。

INVESTIGATION OF SYNTHETIC THERAPY OF LATE STAGE OF CARDIAC CANCEROF ESOPHAGUS

The synthetic treatment of 50 cases of late stage of cardiac cancer of esophagus including supra-clavicle lymph node metastasis mainly by surgical operation supplemented with chemotherapy and radiotherapy was studied. Every patient was given paraplatin 200mg+5% glucose i. v. gtt. once a day for 3 consecutive days with a total dose of 600mg as a course of treatment in one month. Three consecutive courses were given in three months. In cases of residual cancer or local viscera invasion and non-radical operation,regular radiotherapy was given with a dose of 40-70 GY. There were 7 operative complication cases:one fistula of in-trathoraxic anastomosisl. One small fistula of cervicle anastomosis. Two cases of respiratory failure. Two casesof stenosis of anastomosis. One case of pyloric obstruction. The rate of complication was 14%. There were 2cases of death with a mortality of 4%. Cause of deaty:One anastomosis fistula with infection resulting aortic rupture hemorrage. The other died of respiratory failure. Recent follow up findings;Among 48 cases, 18 died mainly of of distal metastasis of relapse- Four cases died within six months after operation. Seven cases within 1 year. Seven cases within 2 years. The total mortality rate was 40%. Recent survival rate within 2 years was 63. 3%.