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￣（６０）钴外照射加腔内￣（１３７）铯治疗晚期直肠癌（附１０例报告）山西省肿瘤医院（０３００１３）刘恩孝，李红卫山西医学院第二附属医院赵德英直肠癌为消化道常见肿瘤，长期以来对不能手术切除的直肠癌，尽管采用放疗、化疗等措施，效果均不理想。我们自１９８３年４月至１９８６年６月采用６０钴外照射加腔内１３７铯治疗手术难以切除的晚期直肠癌１０例。现报告如下：资料与方法一、一般资料：本组中男６例，女４例；年龄３２～６０岁。病变部位直肠中段癌（距肛缘８～１２ｃｍ）２例，直肠下段癌（距肛缘８ｃｍ以下）８例，其中１例为手术复发者。肿瘤侵犯范围：浸润肠管周径）１／２的８例，＜１／２的２例；肿瘤与盆壁固定的９例，与前列腺融合的１例。根据ＵＩＣＣ１９８２年增订及修正的ＴＮＭ恶性肿瘤分类法：Ⅱ期者８例，Ⅳ期者２例。１０例均为直肠单纯腺癌。二、治疗方法：①外照射６０钴全盆腔外照射，组织量每日为２ＧＹ左右，每周约１０ＧＹ。总量４０至４５ＧＹ／４～５周。②腔内照射：用高剂量率西德Ｂｕｃｈｌｅｒ后装１３７铯治疗机腔内治疗８例，用低剂量率法国造１３７铯后装治疗机腔内治疗２例。放射剂量以该机器制造公司提供的剂量曲线图为难。放射源的摆动长度及粘膜
̄ (60) Cobalt-exposed plus intraluminal ̄ (137) 铯 for treatment of advanced rectal cancer (Report of 10 cases) Shanxi Provincial Cancer Hospital (030013) Liu Enxiao, Li Hongwei Zhao Deying, Second Affiliated Hospital of Shanxi Medical College, is a common tumor of digestive tract. For long-term rectal cancer that cannot be surgically removed, radiotherapy and chemotherapy have not been effective. From April 1983 to June 1986, we used 60 cobalt external irradiation and intracavity 137 in the treatment of 10 cases of advanced rectal cancer that were difficult to remove. The report is as follows: Materials and Methods I. General information: There are 6 males and 4 females in this group, aged 32-60 years old. In the lesions, there were 2 cases of rectal cancer (8 to 12 cm away from the anal verge) and 8 cases of lower rectum cancer (8 cm below the anal verge), of which 1 case was recurrence. The extent of tumor invasion: infiltration of the perimeter of the intestine) 1/2 in 8 cases, <1/2 in 2 cases; tumor and pelvic wall fixation in 9 cases, fusion with the prostate in 1 case. According to the TNM malignancy classification revised and revised by the UICC in 1982, there were 8 cases in Phase II and 2 in Phase IV. All 10 cases had rectal adenocarcinoma. Second, the treatment: 1 external irradiation of 60 cobalt whole extraluminal irradiation, the amount of tissue is about 2GY daily, about 10GY per week. Total 40 to 45GY/4 to 5 weeks. 2 Intracavity irradiation: 8 cases were treated with high dose rate Xide Buchler and 137 cases were treated with endovascular treatment, and 2 cases were treated with low dose rate France made 137 cases after treatment. The dose of radiation is difficult with the dose curve provided by the machine manufacturing company. Radiating length and mucous membrane of radioactive sources