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目的 :探讨食管癌钴60 常规放疗加腔内热疗效果。方法 :对 14 0例食管癌患者进行前瞻性分组研究 ,钴60常规分割单纯放射治疗A组 6 0例 ,钴60 常规分割放射治疗加腔内热疗为B组 80例。A组常规分割单纯治疗方法 2GY/次 ,1次 /d ,5次 /周 ,DT6 0～ 6 5GY ,30～ 35次 / 6～ 7周。B组 80例方法钴60 单纯常规分割疗法与A组相同 ,同时配合腔内热疗 1～ 2次 /周 ,4 5min/次 ,肿瘤表面温度 4 3℃共 10次 ,观察其疗效。结果 :1,3,5年生存率分别为 :综合组 80 % (6 4 / 80 ) ,5 0 % (4 0 / 80 ) ,30 % (2 4 / 80 ) ;单放组 6 0 % (36 / 6 0 ) ,2 8.3% (17/ 6 0 ) ,13.3% (8/ 6 0 )。两组之间 1,3,5年生存率比较差异有显著性意义 (χ2 =6 .72 ,P <0 .0 1;χ2 =6 .6 7,P <0 .0 1;χ2 =5 .4 ,P <0 .0 5 )。近期疗效情况比较 ,完全缓解 (CR) ,部分缓解 (PR) ,分别为综合组 4 6 .3% (37/ 80 ) ,4 8.8% (39/ 80 ) ,单放组为 2 5 % (15 / 6 0 ) ,30 % (18/ 6 0 ) ,两者之间差异有显著性意义 (χ2 =6 .6 3,P <0 .0 5 ;χ2 =4 .99,P <0 .0 5 )。结论 :晚期食管癌钴60 常规分割放射治疗的同时配合腔内热疗可明显提高食管癌的局部控制率 ,减少复发率 ,提高 1,3,5年生存率。
Objective: To investigate the effect of cobalt 60 conventional radiotherapy plus endoluminal hyperthermia on esophageal cancer. Methods: 140 cases of esophageal cancer patients were prospectively divided into groups, cobalt 60 conventional radiotherapy alone group A 60 cases, cobalt 60 conventional radiotherapy and endovascular thermotherapy for the B group 80 cases. Group A routinely divided the treatment of 2GY / times, once / d, 5 times / week, DT6 0 ~ 6 5GY, 30 ~ 35 times / 6 ~ 7 weeks. Group B 80 cases of cobalt 60 simple routine division therapy with the same group A, with the endovascular hyperthermia 1 ~ 2 times / week, 4 5min / times, the tumor surface temperature 4 3 ℃ a total of 10 times to observe the effect. Results: The 1, 3, 5 year survival rates were 80% (60/80), 50% (40/80), 30% (2/80) in the combined group and 60% 36/60), 2 8.3% (17/60) and 13.3% (8/60) respectively. The difference of 1, 3 and 5-year survival rates between the two groups was significant (χ2 = 6 .72, P <0.01; χ2 = 6.76, P <0.01; χ2 = 5. 4, P <0. 05). The results of the recent course of treatment were complete response (CR) and partial response (PR), which were respectively 36.3% (37/80), 42.8% (39/80) in the combined group and 25% / 60), 30% (18/60), the difference was significant (χ2 = 6.36, P <0.05; χ2 = 4.99, P <0.05 ). Conclusion: The conventional radiotherapy for advanced esophageal cancer with cobalt 60 combined with endovascular hyperthermia can significantly improve the local control rate of esophageal cancer, reduce the recurrence rate and improve the survival rate of 1, 3 and 5 years.