Relief of Dysphagia by Palliative Intracavitary Brachytherapy for Recurrent Esophageal Cancer Two Cases Report

以姑息性腔內近接治療改善食道癌局部復發的吞嚥困難：兩案例報告

翁益強(Yih-Chyang Weng) ； 曾顯群(Hsien-Chun Tseng) ； 陳琳燕(Leon L. Y. Chen) ； 詹建勝(Jian-Sheng Jan)

《放射治療與腫瘤學》 5卷1期 (1998/03) Pp. 57-62

https://doi.org/10.6316/TRO/199805(1)57

摘要

目的：用姑息性腔內近接治療改善食道癌局部復發的吞嚥困難報告。
材料與方法：自1996年1月兩名食道癌局部復發患者因吞嚥困難接受腔內近接治療，利用a microSelectron-HDR afterloading device, Iridium-192射源與一特別為食道設計的導管來治療。第一例給予治療範圍是長度九公分，半徑是一公分，總劑量是2000 cGy分10 fractions，在兩周完成。第二例給予治療範圍是長度二公分，半徑是一公分，總劑量是2000 cGy分4 fractions, 在十二日內完成。
結果：第一例接受5 fraction後，已經可以喝流質實物，在兩周完成後，無急性副作用，不過患者在治療後第三個月因腫瘤出血及惡質體去世。第二例經近接治療後，患者感到吐口水少很多，生活品質有改善，無急性副作用，不過患者在治療後第二個月因肺炎及惡質體去世。此種治療能改善患者生活品質，且無明顯副作用，除了輕微食道炎。
結論：腔內近接治療可以使曾接受體外放射治療而局部復發食道癌患者的吞嚥困難症狀獲得改善。

關鍵字

腔內近接治療 ； 食道癌

並列摘要

Purpose: To report the result of palliative intracavitary brachytherapy in recurrent esophageal cancer patient.
Materials and Methods Since January 1996, there were two recurrent esophageal cancer patients with symptoms of severe dysphagia who received intracavitary brachytherapy as palliative treatment. The treatment were carried out by a microSelectron-HDR afterloading device with lridium-192 radiation source and a special catheter which was designed for esophageal applications. One patient was treated by a treatment volume including the middle third of the esophagus, 9cm in length, the prescribed dose point was one cm in depth from the central axis of the source. The total treatment dose was 2000 cGy in 10 fractions within 2 weeks. The brachytherapy for another patient was arranged to cover the upper part of the esophageal tumor with 2cm in length and the prescribed dose point was one cm in depth. The total treatment dose was 2000 cGy in 4 fractions within 12 days.
Results The symptoms of the first patient had improved after the first 5 fractions of HDR treatments. He could eat liquid diet after this treatment but odynophagia occurred. Two months later, he expired due to tumor bleeding and cachexia. After 2 fractions of intracavitary brachytherapy, the second patient could swallow some saliva, and the NO tube could be inserted more deeply. He felt better due to less production of saliva after treatment. He expired due to pneumonia in two months. The purpose of improving quality of life could be reached via this kind of treatment without severe acute toxicity except for grade one esophagitis.
Conclusion; Palliative intracavitary brachytherapy can be a successful treatment for relief of dysphagia for patients with recurrent esophageal cancer patients with previous external beam radiotherapy.

並列關鍵字

Intracavitary brachytherapy ； Esophageal cancer