辅助腔内放疗外照射剂量受限的上段食管癌患者近期疗效观察

目的　观察外照射剂量受限的上段食管癌体外照射辅助腔内放疗的近期疗效。方法　自 1999年 1月至 2 0 0 1年 10月采用体外配合腔内放疗治疗此类患者共 2 2例。外照射DT5 0～ 5 4Gy。除 2例外 ,双锁骨上预防性照射DT45Gy。腔内放疗参考点取放射源中心轴外 1cm处 ,参考点剂量 6～ 7Gy/次 ,总量 6～ 13Gy。 结果　食管X线片基本恢复正常 10例 ( 4 5 .5 %) ;明显好转 12例 ( 5 4.5 %)。随访时间 1.5～ 4年 ,放疗后仅 1例出现锁骨上淋巴结转移。未发现食管溃疡、穿孔等严重腔内放疗并发症。全组 1、2年生存率分别为 72 .7%( 16/2 2 )、46.7%( 7/15 )。结论　上段食管癌双锁骨上预防性照射可能有一定价值。对外照射剂量受限的患者 ,辅助腔内放疗是一种安全、有效的治疗手段

The observation of short - term response with adjuvant intracavitary brachytherapy for patients with external radiotherapy dose - limited upper esophageal carcinoma

Objective To observe the short-term response of adjuvant intracavitary brachytherapy plus external beam radiotherapy in patients with dose-limited upper esophageal carcinoma.Methods 22 patients with external beam radiotherapy dose-limited upper esophageal carcinoma form January 1999 to October 2001 were treated with the combination of external beam radiotherapy (EBRT) and intracavitary brachytherapy (IB).The dose of EBRT was 50～54 Gy. 20 patients received prophylactic irradiation 45 Gy in the bilateral supraclavicular regions.The reference dose of IB prescribed at 1 cm distance from the source central axis was 6～7 Gy per fraction with the total dose of 6～13 Gy.Results The complete response rate was 45.5%, and the partial response rate was 54.5%. The period of follow-up was 1.5 to 4 years. Supraclavicular lymphanode metastasis was only found in one patient, and the severe complications of IB such as esophageal ulcer and perforation were no found. The one and two year survival rates were 72.7%(16/22) and 46.7%(7/15).Conclusion Prophylactic irradiation of the bilateral supraclavicular regions should be considered. Adjuvant intracavitary brachytherapy was a safe and effective method for patients with external beam dose-limited upper esophageal carcinoma.