Relationship between 252Cf neutron ray intracavitary irradiation and esophageal carcinoma extensive infiltration on CT / 中华放射医学与防护杂志

ABSTRACT

Objective To explore the relationship between esophageal carcinoma extensive infiltration and lesion length and 252 Cf intracavitary brachytherapy,and to evaluate its prognostic influence.Methods Thirty-two patients with esophageal carcinoma were treated by external beam and 252Cf intracavitary radiation.The patients were first treated with conventional fractionated radiation to a dose of 38 Gy over 4 weeks,with 5 daily fractions of 2 Gy per week,and then treated with external and intracavitary radiation concomitantly (4.0 Gy per fraction,once a week on every Saturday to 12 Gy in 3 fractions).The total dose of external irradiation was 50 Gy.Results The local control rate (LCR) at 1,3 and 5 years was 93.75％,76.70％ and 65.75％ in the patients with ≤5 cm lesion (NMT5 group),and 60.94％,27.08％ and 27.08％ in the patients with ＞5 cm lesion (MT5 group),respectively (x2 =7.01,P ＜ 0.05).The 1-,3-and 5-year survival rate (SR) was 93.75％,56.25％ and 43.75％ in the NMT5 group,and 75.00％,18.75％,12.50％ in the MT5 group,respectively (x2 =5.96,P ＜ 0.05).The LCR at 1,3 and 5 years was 92.31％,73.85％ and 61.54％ in the patients with ≤1.5 cm infiltration depth (NMT1.5 group),and 67.67％,35.45％ and 35.45％ in the patients with ＞ 1.5 cm infiltration depth (MT1.5 group),respectively (x2 =3.87,P ＜ 0.05).The 1-,3-and 5-year SR was 92.31％,61.54％ and 46.15％ in the NMT1.5 group,and 73.68％,21.05％ and 15.79％ in the MT1.5 group,respectively (x2 =6.24,P ＜ 0.05).LCR and SR in the patients with ≤5 cm lesion and ≤2 cm infiltration depth were significantly better than those with ＞ 5 cm lesion and ＞ 2 cm infiltration depth (x2 =10.09,7.97,P ＜ 0.05).Conclusions The patients with ≤5 cm lesion length or those with ≤ 1.5 cm infiltration depth,might become the most adaptable indication for 252 Cf intracavitary radiation.In addition,those patients with ≤2 cm infiltration depth and ≤5 cm lesion length were also suitable for 252Cf intracavitary radiation.