摘要
目的:探讨中晚期胸段食管癌根治术后放疗的价值。方法:116 例病人均行手术治疗,术后病理证实食管上下两断端无癌浸润,其中66例接受术后放疗,放疗一般在术后4～6周开始,照射野包括原发灶部位及纵隔淋巴引流区,部分包括胃左淋巴引流区,锁骨上淋巴结转移者加照锁骨区。照射源采用^(61)COγ线或 6MV-X火线,一般多采用前后对穿野,D_T40Gy/4wks后,改为前后斜野或侧野避脊髓加量 D_T10～26Gy,总 D_T50～66Gy,每周 5次,每次 1.8～2Gy。用 Kaplan-Meier method作生存曲线,生存曲线差异检验用 Log-rank test。结果:术后放疗组的 1、3、5年局控率分别为91.6％、54.1％、48.1％,明显高于单纯手术组 81％、22％、11％,P=0.0438。5年生存率术后放疗组有所提高,但P>0.05。放疗的副反应主要是消化道反应及白细胞减少,对症治疗后均有好转或减轻,病人能够耐受,按计划完成治疗。结论:食管癌根治术后放疗可提高局控率。对生存率的改善有一定作用。
Objective: To evaluate the role of postoperative radiotherapy after radical resection ofthoracic esophageal carcinoma. Methods: This is retrospective review of clinical data from 116 patientswho had negative margin after resection of esophageal carcinoma. Of the 116 patients, 50 underwent noadjuvant treatment (S, 50 patients), and 66 underwent postoperative radiotherapy (SRT, 66 patients).^(60)Co or 6MV photon was used for all patients, using 2～4 fields to deliver 50～60Gy. Kaplan-Meiermethod was used in survival analysis and Log-rank method in comparison. Results: The local controlrates at 1-, 3-and 5-year were 91.6%, 54.1%, and 48.1%, in SRT group and 81%, 22%, and 11%in S group, respectively (P = 0. 0438). Disease-free Survival Rates at 1-, 3-and 5-year were 62%,19%, and 12%, in SRT group and 59.6%. 8.5%. and 2% in S group, respectively (P = 0.7405).Conclusion: Postoperative irradiotherapy after radical resection of esophageal carcinoma can inprovementlocal control rates. However there is no significant difference in survival rate between two groups.
关键词
食管肿瘤
放射疗法
根治术
临床
Esophageal neoplasms/radiotherapy
Esophageal neoplasms/surgery
