食管癌术后复发的治疗结果  

Analysis on the treatment results for recurrent postoperative esophagus

作　　者：桑玫[1] 陈建华[2] 刘海龙[1] 

机构地区：[1]河南省肿瘤医院放疗科,河南郑州450003 [2]河南省肿瘤医院胸外科,河南郑州450003

出　　处：《中国癌症杂志》2000年第5期413-415,共3页China Oncology

摘　　要：目的 :分析食管癌术后复发患者的治疗方法、疗效及其影响因素。方法 :对食管癌胸段鳞癌术后复发的 186例进行回顾性分析。其中复发未治 6 3例 ,单纯放疗 77例 ,单纯化疗 2 5例 ,放疗 +化疗 2 1例。结果 :与未治组比较 ,放疗或合并化疗组复发后生存期较长 ,差异有显著性意义 (P <0 0 5 ) ;单纯化疗组无统计学差异 (P <0 0 1)。COX模型分析显示 :肿瘤浸润深度、淋巴结转移、手术方式及复发后的治疗方式是影响生存率的预后因素。结论 :肿瘤浸润深度和淋巴结转移是影响预后的主要因素 ;提倡颈部吻合术 ;放疗或合并化疗可延长复发患者的生存期 。Purpose:This retrospective study was performed to assess the treatment outcome and prognostic for ercurrent postoperative esophageal cancer. Methods:Between 1995—1998,186 patients who developed recrurrence after curative resection for squamous cell cancer of the thoracic esophagus were analyzed. Of the 186 patients, 63 received no adjuant treatment (NT), 77 received radiotherapy alone (RT), 25 received chemotherapy alone (CT), 21 received radiotherapy combined with chemotherapy (RT+CT). Results:The 0.5,1,2 year survival rates for RT were 75%,49% and 32%; for CT were 65%,52% and 11%; for (RT+CT) were 90%,72% and 26%; for NT were 63%,35% and 16%,respectively. Compared with CT there were significant differences in survival for patients receiving RT alone or combined with CT ( P <0 05). Whereas, there were no significantly different for CT ( P =0 185). COX proportional regression methods demonstrated that depth of invasion of tumor, lymph node metastasis, operative procedure and different regimens of therapy were significant prognostic factors. Conclusions:Stage was the major factor that determined the survival of recurrent postoperative patients. Esophagectomy with cervical anastomsis was recommended, radiotherapy or combined with chemotherapy to be effective in prolonging the survival of patients with recurrences after esophageal resection for cancer. Investigation for more effective regimens of chemotherapy need to be taken.

关 键 词：食管癌 复发 预后 COX模型 

分 类 号：R735.107[医药卫生—肿瘤]