Patonay Péter, Naszály Attila, Mayer Arpád
Hauptstädtisches Zentrum für Radioonkologie und Strahlentherapie, Uzsoki Hospital, Uzsoki u. 29, 1145, Budapest, Ungarn.
Strahlenther Onkol. 2007 Feb;183(2):94-8. doi: 10.1007/s00066-007-1606-4.
To study efficacy and toxicity of radiochemotherapy in esophageal cancer including initial endoluminal high-dose-rate brachytherapy (HDR-BT).
Between 01/1995 and 06/2005, 61 patients with esophageal cancer were treated preoperatively with definitive and palliative intent. Treatment started with intraluminal HDR-BT for recanalization of the esophagus (single fraction size of 8 Gy in 0.5 cm depth, three times, q7d) followed by external-beam radiation therapy (50 Gy total dose, 5 x 2 Gy/week, 25 fractions in 5 weeks). Chemotherapy was started simultaneously with external irradiation (three courses of cisplatin and 5-fluorouracil, q21d).
Swallowing function improved in 55/61 patients (dysphagia classification according to the RTOG), and worsened in 6/61 patients, respectively. Median duration of symptomatic improvement was 11 months, median follow-up 12 months (range 3-68 months). Following simultaneous radiochemotherapy, tumor resectability was achieved in 7/25 patients of the neoadjuvant group, and the histological specimen showed complete remission in 6/7 patients.
These results indicate a favorable effect of simultaneous radiochemotherapy starting with endoluminal HDR-afterloading-( AL-)BT in esophageal cancer.
研究包括初始腔内高剂量率近距离放疗（HDR-BT）在内的食管癌放化疗的疗效和毒性。
1995年1月至2005年6月期间，61例食管癌患者接受了术前确定性和姑息性治疗。治疗开始时采用腔内HDR-BT使食管再通（0.5 cm深度单次分割剂量为8 Gy，共3次，每7天1次），随后进行外照射放疗（总剂量50 Gy，每周5次，每次2 Gy，5周共25次分割）。化疗与外照射同时开始（顺铂和5-氟尿嘧啶共3个疗程，每21天1次）。
55/61例患者吞咽功能改善（根据美国放射肿瘤学会（RTOG）的吞咽困难分级），6/61例患者吞咽功能恶化。症状改善的中位持续时间为11个月，中位随访时间为12个月（范围3 - 68个月）。新辅助治疗组25例患者中，7例在同步放化疗后实现了肿瘤可切除性，7例中有6例组织学标本显示完全缓解。
这些结果表明，食管癌同步放化疗从腔内HDR后装（AL）-BT开始具有良好效果。
