外放射结合腔内照射治疗气管癌和支气管肺癌的疗效观察

目的 探讨气管癌、支气管肺癌腔内放射治疗的价值。方法 4例原发气管癌和22例原发支气管肺癌及14例(18处病变)支气管肺癌术后复发者，外放射采用6MV X射线，剂量为DT30～77Gy(平均52Gy)；腔内照射采用低剂量率^192Ir小线源(1．48BGq)，支气管黏膜参考点剂量为4～6Gy／次，总剂量10～53Gy(中位值28Gy)。结果 37例肿瘤完全消退(CR)，2例部分消退(PR)，1例轻微变化(MR)，3、5年局部控制率分别为75％和65％。23例生存时间≥3年，3年生存率为57．5％。并发症较少见。结论 外放射结合腔内照射治疗对于早期支气管肺癌、局限性气管癌和支气管肺癌术后复发者是有效的治疗手段．长期生存是可能的。

Combined external beam radiotherapy and intraluminal brachytherapy for tracheal and bronchogenic carcinoma

Objective To discuss the role of combined external beam radiotherapy and intraluminal brachytherapy for tracheal cancer and bronchogenic carcinoma. Methods From February 1987 to August 1996, 4 patients with primary tracheal cancer, 22 with primary lung cancer and 14 (18 sites) with postoperative recurrent lung cancer were irradiated. External beam radiotherapy (EBR ) was delivered with linac X-ray to a total dose of 30-77?Gy (median 52?Gy). Intraluminal irradiation (IR ) was delivered with low dose rate 192 Ir (1.48?BGq) to a total dose of 10-53?Gy (median 28?Gy), 4-6?Gy per fraction on the bronchial mucosa. Results Complete response (CR) was obtained in 37 patients, partial response (PR) in 2 and minor response (MR) in 1. The 3-year and 5-year local control rates by Kaplan-Meier method were 75% and 65%. Twenty-three patients have survived for 3 years or longer, with a 3-year survival rate of 57.5%. Complications were rare. Conclusions Combined external beam radiotherapy and intraluminal irradiation is effective for primary lung cancer and localized tracheal cancer, possibly giving long-term survivals.