铱-192高剂量率近距离放射治疗联合外照射治疗不可切除食管癌

Iridium-192 high dose rate brachytherapy combined with external beam irradiation in non-resectable oesophageal cancer.

作者信息

Pakisch B, Kohek P, Poier E, Stücklschweiger G, Poschauko J, Raith J, Quehenberger F, Mayer R, Hackl A

机构信息

Department of Radiotherapy, University of Graz, Austria.

出版信息

Clin Oncol (R Coll Radiol). 1993;5(3):154-8. doi: 10.1016/s0936-6555(05)80314-0.

DOI:10.1016/s0936-6555(05)80314-0

PMID:7688549

Abstract

Forty-eight patients with non-resectable cancer of the oesophagus and oesophagogastric junction (group A: Stage I/II: n = 32; group B: Stage III/IV: n = 16) underwent intralumenal iridium-192 high dose-rate afterloading brachytherapy (5-7 Gy/session, total dose 5-21 Gy, mean 12.4 Gy) and external beam irradiation (Karnofsky > or = 80%: 50-60 Gy/2 Gy per day; Karnofsky 60%-79%: 30 Gy/3 per day). Prolonged satisfactory palliation (intake of at least semi-solid food) was demonstrated in 96% of patients. The mean survival for group A was 19.1 months and that for group B 6.9 months, with a 12-month survival rate of 66% for group A and 0% for group B (P < 0.001). Local tumour response and complication rate were significantly dose related with a predicted response rate of 70.5% and a complication rate of 50% at extrapolated response dose (ERD) 129.3 GY3 (Gy at alpha/beta = 3).

摘要

48例不可切除的食管癌和食管胃交界癌患者（A组：Ⅰ/Ⅱ期，n = 32；B组：Ⅲ/Ⅳ期，n = 16）接受了腔内铱-192高剂量率后装近距离放疗（每次5 - 7 Gy，总剂量5 - 21 Gy，平均12.4 Gy）和外照射（卡氏评分≥80%：50 - 60 Gy，每天2 Gy；卡氏评分60% - 79%：30 Gy，每天3次）。96%的患者实现了长期满意的姑息治疗（至少能摄入半固体食物）。A组的平均生存期为19.1个月，B组为6.9个月，A组的12个月生存率为66%，B组为0%（P < 0.001）。局部肿瘤反应和并发症发生率与剂量显著相关，在外推反应剂量（ERD）129.3 GY3（α/β = 3时的Gy）下，预测反应率为70.5%，并发症发生率为50%。