食管癌根治术后放射治疗的疗效分析  

Effect of postoperative radiotherapy after radical resection for esophageal carcinoma

作　　者：乔红梅 丁富强 宋丽萍[2] 

机构地区：[1]陕西电子四零九医院肿瘤科,陕西宝鸡721006 [2]西安交通大学医学院第一附属医院放疗科,陕西西安710061

出　　处：《现代肿瘤医学》2010年第10期1982-1984,共3页Journal of Modern Oncology

摘　　要：目的:评价食管癌根治术后放射治疗的价值。方法:181例食管癌根治术后患者,其中96例行术后放射治疗,术后3-4周开始放射治疗,放射源为4MV-X射线。上、中段食管癌放射治疗野为双侧锁骨上区野联合纵隔野。下段食管癌放射治疗野为纵隔野,包括胃左动脉淋巴结引流区域。放射剂量:锁骨上区野50Gy/5周,纵隔野50-60Gy/5-6周。结果:总的术后放疗组患者5年生存率相对单纯手术组有显著性差异(P<0.05)。淋巴结阳性者3年生存率两组有显著性差异(P<0.05);阴性者5年生存率两组有显著性差异(P<0.05);Ⅱa期患者5年生存率两组有显著性差异(P<0.01);Ⅱb期患者3年生存率两组有显著性差异(P<0.05);Ⅲ期患者两组生存率无显著性差异。术后放疗组患者吻合口复发率、胸内淋巴结转移率、锁骨上淋巴结转移率均明显下降。两组病例远处转移无显著性差异。放射治疗期间无严重不良反应。结论:食管癌术后放射治疗对淋巴结阴性和阳性者均有好处,可以提高Ⅱ期食管癌患者的长期生存率,有效降低局部复发率及放射野内淋巴结转移率。对晚期食管癌(Ⅲ期)术后局部放射治疗未见明显益处,但可以改善其生活质量。Objective：To evaluate the role of postoperative radiotherapy after radical resection for esophageal carcinoma.Methods：Total of 181 patients after radical resection for esophageal carcinoma,96 of them were treated by radical operation combined with postoperative irradiation.All cases began to be treated by radiation therapy（radioactive source：4MV-X ray） after 3 or 4 weeks.Supraclavicular and mediastinum treatment field for upper,middle section of esophageal carcinoma,mediastinum treatment field for lower section including left gastric artery lymph node drainage region.Supraclavicular radiation dose was 50Gy/5week,mediastinum radiation dose was 50-60Gy/5-6weak.Results：Compared general patients group of postoperative radiotherapy with those of surgical resection only,significant difference was observed（P〈0.05）for 5-year survival rate.Compared patients group of postoperative radiotherapy with those of surgical resection only,significant difference was found（P〈0.05） for 3-year survival rate of lymph node-positive,（P〈0.05） for 5-year survival rate of lymph node-negative,（P〈0.01） for 5-year survival rate of Ⅱa stage patients and（P〈0.05） for 3-year survival rate of Ⅱb stage patients.No significant difference in survival rate between groups of Ⅲ stage patients.Anastomotic stoma recurrence,intrathoracic lymph node metastasis,supraclavicular lymph nodes metastasis decreased significantly for patients of postoperative radiotherapy.No significant difference in distant metastasis between two groups.No severe radiotherapy adverse reaction.Conclusion：Postoperative radiotherapy of esophageal carcinoma has profit to lymph node-negative and lymph node-positive patients improve long term survival rates of Ⅱstage esophageal carcinoma patients and reduce local recurrence and lymph node metastasis in radiation field effectively.No significant offect for advanced esophageal cancer（Ⅲ stage）,but can improve their life quality.

关 键 词：食管癌 术后 放射治疗 

分 类 号：R735.1[医药卫生—肿瘤]