三维适形放疗结合252锎中子腔内后装照射治疗中晚期食管癌的临床研究

目的：探讨三维适形放疗结合锎（252Cf）中子腔内后装照射治疗中晚期食管癌的疗效、不良反应及晚期并发症。方法：92例中晚期食管癌患者全部采用三维适形放疗结合锎（252Cf）中子腔内后装照射治疗。三维适形放疗总剂量为45Gy-54Gy,分25-30次,5-6周完成;腔内照射3-4Gy/次,1次/周,共2-4次,总吸收剂量10Gy-16Gy。结果：治疗结束3个月进食梗阻缓解率为95%。近期疗效：完全缓解（CR）27%,部分缓解（PR）69.6%。1、2、3年局部控制率分别为82%、51%、32%;1、2、3年生存率分别为：78%、35%、18%;急性放射性食管炎发生率为54%;晚期食管狭窄发生率9%;食管穿孔发生率2%。结论：中晚期食管癌采用三维适形放疗结合锎（252Cf）中子腔内后装照射能够迅速而持久地缓解进食梗阻症状,提高局部控制率及生活质量,近期疗效显著,放疗不良反应未见明显增加。

Three-dimensional conformal radiotherapy combined with 252-Cf neutron intracavitary brachytherapy for advanced esophageal carcinoma

Objective：To study the efficacy,toxicity and later period complications of three-dimensional conformal radiotherapy（3DCRT）combined with Cf-252 neutron intracavitary brachytherapy（IBT）in patients with advanced esophageal carcinoma.Methods： Total of 92 patients were included in this study,they all received three-dimensional conformal radiotherapy combined with Cf-252 neutron intracavitary brachytherapy.For 3DCRT,all patient accepted the total dose was 45Gy-54Gy in 5-6 weeks.252Cf brachytherapy was delivered 2-4 fractions at 3Gy-4Gy per fraction per week.The total dose was 10Gy-16Gy.Results： After treatment,the esophageal stricture was reliveved in 95%.In the third month,the complete response rate,partial response rate were 27%,and 69.6%.The 1-,2-,and 3-year local control rates were 82%,51% and 32%;The 1-,2-,and 3-year survival rates were 78%,35% and 18%.The rate of acute esophageal toxicity was 54%.The rate of late esophageal-cardiac stricture was 9%.Conclusion： 252Cf neutron IBT plus 3DCRT can improve the esophageal stricture rapidly and consistly,remarkably improve quality of life of patients and local control,without increasing the toxicity.