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食管癌是一种常见的消化系统肿瘤,手术和放疗是其最主要的根治性治疗方案[1]。然而,食管癌发病较为隐匿,因此,当患者出现相应的临床症状而就诊时,有40%~60%的患者在确诊时就已处于不可手术的局部晚期阶段。对于不可手术的食管癌患者,放疗是其最主要的治疗方案,其中,近距离放疗(brachytherapy,BT)对食管癌患者病灶的治疗及症状的缓解具有辅助作用。目前,应用BT治疗食管癌的主要方式为联合外照射放疗(external beam radiotherapy,EBRT)以提高局部剂量,其适用于早期不适宜手术的食管癌患者的根治性治疗、特定情况下局部晚期食管癌患者的根治性治疗、局部晚期食管癌患者的姑息性治疗及复发转移灶的治疗。我们根据食管癌的诊疗指南及相关文献,从BT技术、施源器、靶区勾画和剂量方案等方面综述BT在食管癌治疗中的应用。
近距离放疗在食管癌治疗中的应用
Application of brachytherapy in the treatment of esophageal cancer
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摘要: 食管癌是一种常见的消化系统肿瘤,手术和放疗是其最主要的根治性治疗方案。放疗对各期食管癌均具有较好的疗效,其中,外照射放疗是主要方法,近距离放疗(BT)作为放疗的分支,对食管癌的治疗具有辅助作用。由于食管是人体的自然管腔,食管局部肿瘤可采用腔内BT进行治疗;复发转移病灶可采用组织间插植BT进行治疗。笔者从BT技术、施源器、靶区勾画以及剂量方案等方面对BT在食管癌治疗中的应用进行综述。Abstract: Esophageal cancer is a common digestive system tumor. Surgery and radiotherapy are the most important radical treatment options for esophageal cancer. Radiotherapy has good curative effects for all stages of esophageal cancer, and external beam radiotherapy is the main method. Brachytherapy (BT), as a branch of radiotherapy, plays an auxiliary role in the treatment of esophageal cancer. Since the esophagus is the natural lumen of human body, intracavitary BT is used to treat local esophageal tumors; interstitial BT is used to treat recurrent metastatic lesions. This paper reviews the application of BT in the treatment of esophageal cancer from the aspects of technique, source applicator, target area delineation and dosage regimen.
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Key words:
- Esophageal neoplasms /
- Brachytherapy /
- Antineoplastic protocols
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