摘要
目的明确和评价临床可手术切除食管癌放射治疗的疗效,分析其治疗失败的原因,同时对选择性淋巴结照射的可行性进行分析。方法对可能影响入组食管癌患者预后的生存因素进行分析,并对其死亡原因进行详细分析。同时对进行了选择性淋巴结照射的21例患者的生存相关情况与其他102例患者进行了比较研究。疾病治疗失败原因分为复发、远处转移和淋巴结转移。结果全组患者1、3、5年总生存率及局部控制率分别为87.8%、47.2%、36.5%和89.7%、67.7%、49.0%。多因素分析显示病变X线长度、临床N分期及近期疗效是其独立的预后因素。选择性淋巴结照射并未给患者生存及局控率上带来益处,但对纵膈淋巴结转移和(或)远处转移患者有益(χ2=5.778,P=0.016)。结论三维适形放射治疗可作为早期食管癌有效的治疗方式之一;选择性淋巴结照射可能会降低淋巴结转移率,但需要后续进一步研究证实,是否能提高患者的生存率也有待进一步研究。
Objective To evaluate the curative effect of radiation therapy, failure causes and the feasibility of elective nodal irradiation on early esophageal carcinoma. Methods We analyzed the prognostic factors and failure cause for 123 patients with squamous cell carcinoma and clinical T1-2N0-1M0 stage esophageal carcinoma. And we analyzed those 21 patients who received elective nodal irradiation. The pattern of the failure after treatment included recurrence, distant metastases and lymph nodal metastases. Results The 1-, 3-, and 5-year overall survival rates were 87.8%, 47.2% and 36.5%, respectively. The 1-, 3-, and 5-year local control rates were 89.7%, 67.7% and 49.0%. Cox multivariate model showed that the length of tumor in X-rays, clinical N stage and the response to curative effect were independent prognostic factors. Elective nodal irradiation were not beneficial to over survival rates or local control rates, but beneficial to local nodal and distant failure(χ2=5.778,P=0.016). Conclusion Three-dimensional conformal radiotherapy could be one of the best radiation treatment regimens for early esophageal carcinoma. Elective nodal irradiation may be effective for lowering the risk of regional nodal failure while its benefit to overall survival is still needed further evaluation.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2014年第6期657-662,共6页
Cancer Research on Prevention and Treatment
关键词
食管肿瘤
放射治疗
三维适形放射治疗
预后
累及野照射
选择性淋巴结照射
Esophageal neoplasms
Radiotherapy
3-dimensional conformal radiotherapy
Prognosis
Involved field irradiation
Elective nodal irradiation
