腔内热疗合并体外放射治疗食管癌的疗效  

Results of intraluminal hyperthermia combined with external irradiation for esophageal carcinoma

作　　者：王建华[1] 张楚敏[1] 张景伟[1] 李鼎九[1] 

机构地区：[1]河南省肿瘤医院放射治疗科,郑州450003

出　　处：《中华放射肿瘤学杂志》2001年第2期88-90,共3页Chinese Journal of Radiation Oncology

摘　　要：目的　比较食管腔内微波加温合并体外放射治疗食管癌与单纯放射治疗的疗效。方法　对 12 5例食管癌进行前瞻性分组研究。食管腔内加温合并体外照射 (R +H)组 5 9例 ,单纯体外照射 (RT)组 6 6例 ,R +H组外照射DT40Gy ,腔内加温 1～ 2次 /周 ,45min/次 ,要求肿瘤表面温度 >43℃。RT组外照射DT6 0Gy ,2Gy/次 ,5次 /周。结果　近期疗效显示R +H组完全缓解率达 46 .0 % ,RT组为2 4.0 %。差异有显著性意义 (P <0 .0 5 )。 1、5、10年生存率R +H组分别为 81.2 %、2 3.7%和 15 .2 % ,RT组分别为 5 9.0 %、16 .7%和 7.5 %。将平均T90 ≥ 43℃的病例进行统计 ,R +H组的 5、10年生存率是 2 6 .9%和 17.3% ,分别高出对照组 10 .2 %和 9.8%。结论　食管腔内加温合并体外放射治疗可以提高食管癌的局部控制率 ,近期疗效和远期疗效均高于对照组。局部控制率的高低与加温的次数无明显关系 ,关键在于每次的加温质量 (T90 的高低 )。Objective To compare the long term survival rate between intraluminal microwave hyperthermia combined with external irradiation and radiotherapy alone. Methods A randomized trial on intraluminal microwave hyperthermia combined with external irradiation (R+H) versus radiotherapy alone (R) in esophageal cancer was performed from February 1986 to February 1988. In the R group, radiation was given by 8 MV X ray with 2 Gy/fraction, 5 fractions per week with a total dose of 60 Gy/6 weeks. In the R+H group, the radiation was given with a total dose of 40 Gy/4 weeks. Intraluminal 915 MHz microwave hyperthermia was given with a nominal temperature of 43.5℃ at the margin of the tumor surface, 45 minutes/fraction, once or twice a week for 4 8 fractions. Results The 1 , 5 , 10 years survival rates were 81.2%, 23.7% and 15.2% in group R+H, and 59.0%, 16.7% and 7.5%, in the R group, respectively. For 52 patients who received hyperthermia with T90 equal to or higher than 43℃, survival rates at 5 and 10 year were 26.9% and 17.3% for R+H group, and 10.2% and 9.8% for the R group. Conclusions Intraluminal hyperthermia plus radiotherapy is able to improve the rate of local control in esophageal cancer. Hyperthermia plus radiotherapy gives a better long term survival as compared to radiotherapy alone. There is no apparent correlation between the number of hyperthermia fractions and the rate of local control.

关 键 词：食管肿瘤 放射治疗 加温治疗 微波加温 热剂量 

分 类 号：R735.1[医药卫生—肿瘤] R730.5[医药卫生—临床医学]