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目的 探讨内窥镜下早期食管癌的放疗疗效。方法 17例早期食管癌经内窥镜及碘染色确诊,并经活检病理证实。6MVX线3个野外照射,先常规分割30Gy ,15分次,3周完成;复位后行后程加速超分割照射,1.5Gy/次,2次/d ,间隔6h以上,共2 0～2 4Gy ,14～16分次,9～10d完成。生存率分析采用Kaplan Meier法。结果 17例早期食管癌放疗1、3、5年生存率分别为10 0 %、86 %、6 6 %。病变长度≤3cm的5年生存率为10 0 % ,>5cm的为4 9% (P =0 .111)。病变厚度≤5mm的5年生存率为10 0 % ,>5mm的为4 5 % (P =0 .10 2 )。结论 早期食管癌放疗是有效的方法,照射野大小应根据内窥镜及碘染色所确定的病变范围而定;常规分割30Gy15分次3周+后程加速超分割2 0～2 4Gy14～16分次9～10d照射是可行的。
Objective To investigate the efficacy of endoscopic radiotherapy for early esophageal cancer. Methods 17 cases of early esophageal cancer were diagnosed by endoscopy and iodine staining and confirmed by biopsy. 6MVX line 3 field irradiation, the first conventional segmentation 30Gy, 15 times, 3 weeks to complete; after the reset line accelerated hyperfractionation, 1.5Gy / time, 2 times / d, more than 6h intervals, a total of 20 ~ 4GY , 14 ~ 16 times, 9 ~ 10d to complete. Survival analysis using Kaplan Meier method. Results The survival rates of 1, 3 and 5 years after radiotherapy in 17 cases of early esophageal cancer were 100%, 86% and 66% respectively. The 5-year survival rate was 10% for lesions ≤ 3 cm and 49% for> 5 cm (P = .111). The 5-year survival rate of lesion thickness ≤5 mm was 100% and that of> 5mm was 45% (P = .10 2). Conclusion Early esophageal cancer radiotherapy is an effective method, the size of the radiation field should be based on endoscopic and iodine staining determined by the extent of the lesion; conventional segmentation 30Gy15 points 3 weeks + after the accelerated hyperfractionation 20 ~ 4GY14 ~ 16 The next 9 ~ 10d irradiation is feasible.