23例原发气管癌的放射治疗

目的　评价原发气管癌放射治疗的意义及加腔内放射治疗后能否提高肿瘤局部控制率。方法　原发气管癌２３ 例，其中单纯放射治疗１３ 例，术后复发或残留行放射治疗１０ 例。结果　（１） 全组１ ，５ ，１０ 年生存率分别为６５ ．２ ％ ，２６ ．１ ％ ，５ ．９ ％ ，中位生存时间为２５ 个月。术后复发或肿瘤残留再放射治疗与单纯放射治疗的中位生存时间分别为５２ 个月与２３ 个月。根治放射治疗组与姑息放射治疗组的１ ，３ ，５ 年生存率分别为７６ ．９ ％ ，４６ ．２ ％ ，４６ ．２ ％ 与３０ ．０ ％ ，２０ ．０ ％ ，１０ ．０ ％ 。肿瘤局部控制率为３０ ．４ ％ （７／２３） ，其中单纯外照射１ 例，加腔内放射治疗４ 例，术后＋ 放射治疗２ 例。（２） 病理类型对生存率无明显影响。（３） 第１ 程放射治疗后局部未控复发再放射治疗７ 例，未治７ 例，其１ ，３ ，５年生存情况前者分别为６／７ ，３／７ ，１／７ ，后者１ 年为２／７ ，无２ 年以上生存者。结论　（１） 对不能手术、术后复发或肿瘤残留的患者，放射治疗是主要的、有效的治疗手段之一。（２） 加用腔内放射治疗可提高肿瘤局部控制率。（３） 复发后再程放射治疗仍可缓解症状延长部分患者寿命。

Radiotherapy for primary tracheal carcinoma 23 cases report

Objective To evaluate the value of radiotherapy for primary tracheal carcinoma and whether combination of intracavity irradiation can improve the local control rate.Methods From 1962 to 1992, 23 cases of primary tracheal carcinoma were retrospectively analyzed. 13 cases were uniquely treated by a radiotherapy, and 10 cases by radiotherapy due to a postsurgery recurrent or carcinoma residual. Results (1) The survival rate of the whole group in 1 , 5 and 10 year are 65.2%, 26.1% and 5.9% respectively. Median survival time is 25 months. The median survivals times of second course radiotherapy for recurrent of postsurgery or carcinoma residual, and of unique radiotherapy are 52 months and 23 months respectively. The 1 , 3 and 5 year survival rates for radical irradiation or palliative irradiation are 76.9%, 46.2% and 46.2%; 30.0%, 20.0%, 10.0% respectively. The local control rate of the tumor is 30.4%(7/23), thereunto unique external radiotherapy has one case, adjuvant intracavity radiotherapy has 4 cases and postsurgery plus radiotherapy 2 cases. (2) Pathology type: It does not affect survival rate. (3) It is 7 cases that second course radiotherapy was applied due to relapse of local lost control after first radiotherapy, and 7 cases were untreated: its 1 , 3 and 5 year survival rates are 6/7,3/7,1/7;2/7 and there is not 2 year survival for the later case. Conclusions (1)The radiotherapy is still one of main and efficient treatments for inoperable cases or those patients who are recurrence or residual after surgery. (2)It can raise the local controlling rate of the tumor and improve survival rate with adjuvant brachytherapy. (3) It will have the effect of releasing the symptoms and prolonging the survival time to some patients by the way of second course radiation after recurrence.