食道癌の放射線治療

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タイトル別名
  • Radiation Therapy in Esophageal Cancer
  • ショクドウガン ノ ホウシャセン チリョウ ソノ Xセンゾウ ニ ヨル カタ ブンルイ オ チュウシン ト シテ
  • そのX線像による型分類を中心として

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Carcinoma of the esophagus still has placed in a poor result in the field of cancer. However, the advances in radiation therapy-the use of rotation or multiple perithoracic ports and supervoltage radiation-made possible the introduction of sufficiently high and homogeneous doses such as are considered necessary for the sterilization of esophageal cancer, and therefore some treated cases can be expected to survive more than five years.<BR>Both surgery and radiation therapy are local therapy and are no significant difference in either therapy, for this reason, it is possible to do the radial therapy by irradiation alone. Howevere the healing process of radiation therapy is quite different from surgery, therefore, in an attempt to find more definite guides for the selection of patients for either surgery or radiation therapy, it should be carefully considered. In choosing indication, the length and type of a filling defect by barium swallow radiographic study of the esophageal cancer are most important factors.<BR>Esophageal cancer tends to infiltrate in upward and downward through the esophageal wall and spread frequently into the mediastinal structures. These form of involveme nt are usually accurately provided on the basis of roentgen study of the esophageal cancer with many types, it is likely that a small filling defect is well controlled and prognosis is better than that exceeding 5 cm in length.<BR>In general, there are two types in growing form of the esophageal cancer; one is the exophytic and comparatively localized type, another is the endophytic and infiltrative type. These type of growth also correlate with patients prognosis, so they can be available for classification on the roentgen findings. Our classification by roentgen findings is as follows:<BR>1) Early stage type<BR>2) Non-ulcerated type: Polypoid type, Cauliflower type, Hill-like type<BR>3) Superficial ulcerted type: Saw type<BR>4) Ulcerated type: One sided ulcer type, spiral type<BR>5) Sclerotic type<BR>It appeares that the type of Polypoid, Cauliflower and Saw are suitable for the radiation therapy, on the other hand, Ulcerated type should be tried the combined therapy with surgery and radiation therapy.

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