73例食管癌侵及气管的放射治疗分析

目的探讨食管癌侵及气管的放射治疗的意义和效果。方法回顾性分析73例食管癌侵及气管患者的放射治疗效果，全部病例结合临床症状、食管造影、纤维胃镜、纤维支气管镜、CT或MRI确诊，放射治疗采用钴60^C。6、15MV X线常规外照射。结果未完成计划的6例患者在治疗后半年内死亡，照射40Gy以上者其胸痛、声音嘶哑、咯血及吸气性呼吸困难缓解率分别为87．2％、74．1％、99.3％、100．0％，照射剂量50～70Gy的患者0．5、1、2、3年生存率分别为79．5％、68．5％、27．4％和9．6％。结论食管癌侵及气管为局部晚期肿瘤，行积极的放疗可明显改善患者生存质量并延长生存时间，能够完成计划者照射剂量以60-70Gy为宜，病灶大小、侵犯气管部位对生存率没有影响。

Analysis of Radiotherapy of Esophagus Cancer Invading Trachea or Main Bronchus

Objective To evaluate the effects and meaning of radiotherapy of esophagus cancer invading trachea or main bronchus. Methods 73 esophagus cancer invading trachea or main bronchus were analyzed retrrospetively. All cases were confirmed combining clinical symptom, the esophagus ray examination,gastroscopy,fiberoptic bronchoscopy,the CT or MRI 60^Co or 6,15 MV X. Results 6 cases did not finish radiotherapy plan and all died in half year, patients receiving more than 40Gy,chest ache,voice hoarseness,emptysis and inspitation dyspnea symptom decreased rate were 87.2%, 74.1%, 99.3 %, 100% respectively, patients received 50-70Gy, the 0.5,1,2,3 year survival rates were 79.5% ,68.5% ,27.4% and 9.6%. Conclusion Esophagus cancer invading trachea or main bronchus is local advanced tumor,radiotheropy can improve the quality of patients,life and extend survival time obviously, receveing 60-70Gy is proper, survival rate make no difference of focus tumor size and the sites of trachea invaded.