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目的 :探讨食管癌外照射加腔内后装治疗的价值及后装治疗合适的每次剂量与总剂量。方法 :1992年 10月至 1993年 5月 112例经病理证实的食管癌患者 ,外照射加腔内照射 5 2例 ,单纯外照射 60例 ,分组比较。并将综合组的剂量分组进行生存率的比较。结果 :综合组的 1、3、5年生存率分别为 73 %、3 2 .7%、2 3 % ;对照组的 1、3、5年生存率分别为 4 1.6%、18.3 %、8.3 %。经统计学处理有明显差异。其中病变长度小于或等于 5cm外照射加后装的病例 1、3、5年生存率比单纯外照射明显增高 ,统计学有显著性差异。而长度大于 5cm的病例 ,两组病人差别不大。结论 :外照射综合高剂量率后装治疗对病灶小于或等于 5cm的食管癌可明显提高疗效。掌握后装剂量是提高生存率的关键。外照射 60Gy后再加腔内后装 5Gy/次 ,总量 15Gy效果最佳
Objective: To investigate the value of esophageal cancer external beam plus intracavitary after-treatment and the appropriate dose and total dose for after-treatment. Methods: From October 1992 to May 1993, 112 patients with pathologically confirmed esophageal cancer were treated with external irradiation plus endovascular irradiation in 52 cases and external irradiation alone in 60 cases. The combined groups were divided into groups to compare the survival rates. Results The 1, 3, 5-year survival rates of the integrated group were 73%, 32.7% and 23% respectively. The 1, 3, 5-year survival rates of the control group were 41.6%, 18.3% and 8.3% . There are obvious differences after statistical processing. Among them, the 1, 3, 5-year survival rates of patients with external lesion length less than or equal to 5cm and after loading were significantly higher than those of external radiation alone, and there was a statistically significant difference. The length of more than 5cm cases, two groups of patients is not very different. Conclusion: The combination of external dose and high dose rate of post-irradiation treatment of esophageal cancer less than or equal to 5cm can obviously improve the curative effect. Mastering the dosage after loading is the key to improving survival. After the external irradiation 60Gy and then add the cavity after loading 5Gy / times, the total amount of 15Gy best