食管癌狭窄支架置入后放射治疗的对照研究

目的　探讨食管癌支架置入后放射治疗的临床疗效。方法　 96例食管癌分为 :支架置入后照射治疗组和单纯照射治疗组 ,每组 48例 ,全部病例均经病理学证实为鳞癌 ,研究组行食管支架置入后照射治疗 ,对照组不行支架置入直接进行照射治疗。放射治疗分为二段 ,第一段治疗 :直线前后垂直照射 ,剂量为 40 0 0Gy ;第二段治疗 :根据病灶不同定位旋转角度照射 ,剂量为 3 0 0 0Gy。 结果　研究组 48例 ,临床吞咽症状改善好转或恢复正常 ,通畅率 10 0 % ,局部肿瘤有效控制、患者体质增强体重增加率占 10 0 % ,无照射治疗严重并发症 ,追踪随访 1、2、3年生存率分别为 98.9% ( 4 2 /4 8)、66.7% ( 3 2 /4 8)、41.7% ( 2 0 /4 8) ,对照组吞咽改善好转率 12 .5 % ,体质体重增加为 0 ,追踪随访 1、2、3年生存率分别为 85 .4% ( 4 1/4 8)、3 7.5 % ( 18/4 8)、16.7% ( 8/4 8)。经统计学处理P <0 .0 1表明研究组治疗效果明显优于对照组。结论　食管癌支架置入后放射性治疗是一种改善临床症状的有效方法 ,对控制局部肿瘤发展效率高 ,并发症和副反应少 ,可以提高患者的生活质量和生存时间。

Comparative Study of Radiotherapy for Malignant Stricture of Esophagus Carcinoma after Stent Deployment

Objective To evaluate the clinical effects of radiotherapy for malignant strictures of esophagus carcinoma after stent deployment. Methods 96 cases of malignant strictures of esophagus carcinoma were divided into 2 groups. The study group was treated with radiotherapy after stents deploynent; the comparative group was only treated with radiotherapy. There were 48 cases in each group, all of them were diagnosed as squarmous cell carcinoma pathologically. Radiotherapy was performed in 2 stages for both group: the lesions were radiated with a dose of 4000Gy in the first stage; in the second stage rotary radiations with a dose of 3000Gy were performed according to the location of the lesions. Results In the study group, the swallow symptoms were relieved or renewed to normal (100%), the lesions decreased and the patients' body weight were increased 100% without any side effects of radiotherapy; the survive rate was 98.9%(42/48), 66.7%(32/48), 41.7%(20/48) for 1, 2, 3 years. In the control group, the survive rate was 85.4%(41/48), 37.5%(18/48), 16.7%(8/48) for 1, 2, 3 years respectively, and the clinical effects were much better in study group than in control group. Conclusion Radiotherapy of esophagus carcinoma after malignant strictures were stented is an effective and convenient method with lower complications and side effects, it could improve the patient's survival rate.