导管化疗加放疗及X-刀治疗食管癌60例

目的从Ｘ线角度对照观察导管化疗加放疗及Ｘ刀治疗晚期食管癌后的疗效．方法晚期食管癌６０例，其中经导管化疗加放疗３０例（综合组），Ｘ刀治疗３０例（Ｘ刀组）．各治疗组前、中、后各摄食管Ｘ线吞钡片充盈、粘膜象各一张，以观察疗效．结果治疗后总生存率，综合组１，３，５ａ分别为７３％，４４３％，２７３％．Ｘ－刀组由于开展近２ａ２ｍｏ，除一例治疗后形成食管气管瘘死亡外，其余仍在观察．治疗效果和病变长度、Ｘ线分型、病理类型及有否转移有关．Ｘ刀治疗组治疗后食管狭窄率明显高于综合组．通过本组病例的Ｘ线对照分析Ｘ线吞钡观察晚期食管癌治疗前后的改变情况可作为判断预后的标准之一．结论从Ｘ线角度观察导管化疗加放疗治疗晚期食管癌疗效好于Ｘ－刀治疗，且Ｘ刀治疗狭窄率明显增高

Catheter chemotherapy plus radiotherapy or X knife in treatment of esophagus cancer

AIM To compare the therapeutic effect of catheter chemotherapy plus radiotherapy or X knife on esophagus cancer. METHODS Advanced esophagus cancer patients were treated with catheter chemotherapy plus radiotherapy (group A, n =30), or treated by X knife (group B, n =30). Before, during and after the treatment, X ray film of esophagus with swallowing barium filling and mucosa image was taken to follow up the therapeutic effect. RESULTS After the treatment the general survival rate of group A was 73 0%,44 3% and 27 3% respectively for the first, third and fifth year. Because the X knife was only used for two years and two months, except one patient who died of esophagus tracheal fistula, the others are still being observed so far. The therapeutic efficiency was related to the duration of the esophagus cancer, X ray classification, pathologic classification and the metatasis. The esophageal stenosis rate of the group B was significantly higher than that of group A. By X ray film aralysis and esophagus barium meal examination the changes of the late esophagus cancer before and after treatment could be one of the standards for prognosis. CONCLUSION In the treatment of esophagus cancer, the catheter chemotherapy plus radiotherapy are more effective than the X knife treatment, and the stenosis rate caused by X knife was significantly higher than the former.