食管癌根治术后吻合口复发的放射治疗  

Radiotherapy for anastomotic recurrence after radial resection of esophageal carcinoma

作　　者：单娟[1] 潘振华[1] 袁翎[1] 

机构地区：[1]河南省肿瘤医院放疗科,河南郑州450008

出　　处：《中华肿瘤防治杂志》2010年第15期1226-1228,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为了探讨食管癌根治术后吻合口复发的放疗疗效及预后因素,对确诊为食管癌且术后病理切缘阴性的45例患者行根治术后吻合口复发,术后病理高分化鳞癌6例,中-低分化鳞癌39例;复发时间在术后2～38个月,中位时间为13个月;单纯吻合口复发13例,伴纵隔淋巴结转移32例。全部病例接受放疗,6～8周DT60～70Gy/30～35次。结果:复发后1、3及5年生存率分别为35.56%(16/45)、11.11%(5/45)和0;单纯吻合口复发1、3和5年生存率分别为76.92%(10/13)、30.77%(4/13)和0;伴纵隔淋巴结转移1、3和5年生存率分别为18.75%(6/32)、3.13%(1/32)和0。单因素分析显示,病理、术后分期、复发时间、近期疗效和复发部位对生存期有影响;多因素分析显示,复发部位影响预后,P=0.022。初步研究结果提示,放疗是食管癌根治术后吻合口复发患者的有效治疗手段,单纯吻合口复发者的预后优于伴纵隔淋巴结转移者。This study was to assess the role of radiotherapy for anastomotic recurrence after radial resection of esophageal carcinoma and prognosis.Forty-five patients who had negative margin but later developed anastomotic recurrence after resection of esophageal carcinoma were reviewed.All the patients received surgery as a primary treatment.The duration from operation to recurrence were 2-38 months with a median of 13 months.Thirteen patients had anastomotic recurrence only and the remaining 32 patients had both anastomotic recurrence and mediastinal lymph node methastasis.All the patients accepted radiotherapy,the doses were 60-70 Gy/30-35 f.The overall survivals at 1-,3-,5-year were 35.56%（16/45）,11.11%（5/45）,0 respectively;The survivals at 1-,3-,5-year were 76.92%（10/13）,30.77%（4/13）,0 for patients with anastomotic recurrence only and 18.75%（6/32）,3.13%（1/32）,0 for patients with both anastomotic recurrence and mediastinal lymph node methastasis.The single factor analysis showed that the histology,pathologic stage,recurrence time,curatived effect,and recurrence site had an influence on the survival period.Multiwariate analysis showed that the recurrence site was an important prognostic factor （P=0.022）.In conclusions,radiotherapy was effective and safe in the treatment of anastomotic recurrence after radial resection of esophageal carcinoma.Radiotherapy for anastomotic recurrence is able to improve the survival.

关 键 词：食管肿瘤/放射疗法 吻合口复发 预后 

分 类 号：R735.1[医药卫生—肿瘤]