食管癌锁骨上淋巴结转移113例放射治疗的疗效和预后因素分析  

Clinical analysis of radiotherapy for 113 patients with esophageal carcinoma with supraclavicular lymph node metastasis.

作　　者：蔡平[1] 刘庆深[1] 李惜辉[1] 

机构地区：[1]汕头市中心医院放射治疗科,广东汕头515031

出　　处：《临床和实验医学杂志》2006年第4期317-318,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨食管癌锁骨上淋巴结转移放疗后的疗效和预后因素.方法接受放射治疗的食管癌锁骨上淋巴结转移患者共113例.中位随访时间33个月（3～60个月）.其中食管癌治疗后锁骨上淋巴结转移26例,治疗时发现锁骨上淋巴结转移87例.所有锁骨上淋巴结转移患者均行连续超分割放射治疗,总剂量为36～75 Gy/5～7周,2.2～2.4 Gy/d.结果在锁骨上淋巴结放射治疗结束时86例（76.1%）达完全消退（CR）;21例（18.6%）达部分消退（PR）.全组患者中位生存期12个月.1、3和5年生存率分别为50.4%、10.6%和1.8%.多因素分析显示,锁骨上转移淋巴结的直径（P=0.001）、单侧还是双侧（P=0.021）和转移的数目（P=0.040）对放射治疗后能否达到CR差异有统计学意义;但对于生存率只有淋巴结的直径差异有统计学意义（P=0.010）.结论在食管癌治疗后发现锁骨上淋巴结转移的患者给予进一步的治疗仍能获得一定的治疗效果.Objective To analyze the factor affecting the resuhs and the prognoses of radiotherapy for esophageal carcinoma with supraclavicular lymph node metastasis, Methods 113 primary esophageal carcinoma patients with supraclavicular lymph node metastasis were studied. The median follow - up time was 33 months （ 3 - 60months）, Twenty - six patients were found metastasis of supraclavicular lymph nodes after primary esophageal carcinoma had been treated , and 87 patients were found the metastasis when they were diagnosed. All patients were treated with the ccontinuative hyperfractionated radiotherapy. The total dose was 36 - 75 Gy/5 - 7 w ,2.2 - 2.4 Gy/d of the supraclavicular field. Results Of the 113 patients, complete regTession （CR） was achieved in 86（76.1% ） ;partial regression （PR） was achieved in 21 （ 18.6% ）. The 1 - , 3 - and 5 - year survival rates were 50.4%, 10.6%, 1.8%, respectively with the median survival time of 12 months. Multivariate analysis showed that the diameter of supraclavicular metastasis lymph node （ P = 0.001 ）, whether one side supraclavicular lymph node metastasis or both of two sides（ P = 0. 021 ）, and the number of supraclavicular lymph node metastasis （ P =0. 040） showed the statistical significant for the result of CR af ter radiotherapy, but only the diameter of supraclavicular metastasis lymph node was independent factor influencing the survival（ P = 0. 010 ）. Conclusion The patients of esophageal carcinoma with supraclavicular lymph node metastasis can get some therapeutic efficacy with advanced radiotherapy.

关 键 词：食管肿瘤 放射治疗 锁骨上淋巴结转移 预后 

分 类 号：R735.1[医药卫生—肿瘤]