中华放射医学与防护杂志

盖晓惠,高献书,蔺强,李志刚,刘惠明,王永强.²⁵²Cf腔内照射治疗食管癌疗效与病变外侵程度的相关性[J].中华放射医学与防护杂志,2013,33(1):46-49

²⁵²Cf腔内照射治疗食管癌疗效与病变外侵程度的相关性

Relationship between ²⁵²Cf neutron ray intracavitary irradiation and esophageal carcinoma extensive infiltration on CT

投稿时间：2012-08-21

DOI：10.3760/cma.j.issn.0254-5098.2013.01.012

中文关键词: 食管癌/放射治疗内照射/后装治疗 ²⁵²Cf CT浸润深度

英文关键词:Esophageal carcinoma/radiotherapy Intracavitary radiation/brachytherapy ²⁵²Cf CT extensive infiltration

基金项目:

作者	单位
盖晓惠	071000 保定,河北大学附属医院放疗科
高献书	北京大学第一医院放疗科
蔺强	华北石油管理局总医院肿瘤科
李志刚	071000 保定,河北大学附属医院放疗科
刘惠明	长治市灵顿肿瘤医院放疗科
王永强	071000 保定,河北大学附属医院放疗科

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中文摘要:

目的观察²⁵²Cf中子射线内照射治疗食管癌的疗效与食管肿瘤外侵程度及病变长度的关系及对患者预后的影响。方法对32例食管癌患者进行外照射加²⁵²Cf腔内照射治疗,常规外照射38 Gy/19次(2 Gy/次,1次/日,5次/周)后,开始内外照射同期进行,内照射4 Gy/次,1次/周,共12 Gy/3次,外照射总量为50 Gy。结果病变长度≤5 cm患者1、3、5年局部控制率及生存率明显高于>5 cm患者, 分别为93.75%、76.70%、65.75%和93.75%、56.25%、43.75%(χ²=7.01,P<0.05);60.94%、27.08%、27.08%和75.00%、18.75%、12.50%(χ²=5.96,P<0.05)。最大浸润深度≤1.5 cm患者1、3、5年局部控制率及生存率明显高于最大浸润深度>1.5 cm患者, 分别为92.31%、73.85%、61.54%和92.31%、61.54%、46.15%(χ²=3.87,P<0.05);67.67%、35.45%、35.45%和73.68%、21.05%、15.79%(χ²=6.24,P<0.05)。病变长度≤5 cm且浸润深度≤2.0 cm患者与病变长度>5 cm且浸润深度>2.0 cm患者比较, 局部控制率和生存率差异有统计学意义(χ²=10.09、7.97,P<0.05)。结论食管癌病变长度≤5 cm,CT最大外侵≤1.5 cm,可能是²⁵²Cf中子射线腔内照射的最好适应证。而当病变长度≤5 cm且肿瘤最大浸润深度≤2 cm时也可作为²⁵²Cf中子射线腔内照射的较佳选择。

英文摘要:

Objective To explore the relationship between esophageal carcinoma extensive infiltration and lesion length and ²⁵²Cf intracavitary brachytherapy, and to evaluate its prognostic influence. Methods Thirty-two patients with esophageal carcinoma were treated by external beam and ²⁵²Cf intracavitary radiation. The patients were first treated with conventional fractionated radiation to a dose of 38 Gy over 4 weeks, with 5 daily fractions of 2 Gy per week, and then treated with external and intracavitary radiation concomitantly (4.0 Gy per fraction, once a week on every Saturday to 12 Gy in 3 fractions). The total dose of external irradiation was 50 Gy. Results The local control rate (LCR) at 1, 3 and 5 years was 93.75%, 76.70% and 65.75% in the patients with ≤5 cm lesion (NMT5 group), and 60.94%, 27.08% and 27.08% in the patients with >5 cm lesion (MT5 group), respectively (χ²=7.01,P<0.05). The 1-, 3-and 5-year survival rate (SR) was 93.75%, 56.25% and 43.75% in the NMT5 group, and 75.00%, 18.75%, 12.50% in the MT5 group, respectively (χ²=5.96,P<0.05). The LCR at 1, 3 and 5 years was 92.31%, 73.85% and 61.54% in the patients with ≤1.5 cm infiltration depth (NMT1.5 group), and 67.67%, 35.45% and 35.45% in the patients with >1.5 cm infiltration depth (MT1.5 group), respectively (χ²=3.87,P<0.05). The 1-, 3-and 5-year SR was 92.31%, 61.54% and 46.15% in the NMT1.5 group, and 73.68%, 21.05% and 15.79% in the MT1.5 group, respectively (χ²=6.24,P<0.05). LCR and SR in the patients with ≤5 cm lesion and ≤2 cm infiltration depth were significantly better than those with >5 cm lesion and >2 cm infiltration depth (χ²=10.09,7.97,P<0.05). Conclusions The patients with ≤5 cm lesion length or those with ≤1.5 cm infiltration depth, might become the most adaptable indication for ²⁵²Cf intracavitary radiation. In addition, those patients with ≤2 cm infiltration depth and ≤5 cm lesion length were also suitable for ²⁵²Cf intracavitary radiation.

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