经左胸食管癌根治术后复发模式回顾分析  

Retrospective analysis of relapse pattern after radical surgery for left thoracic esophageal carcinoma

作　　者：张正荣[1] 袁昕[1] 殷旭东[1] 汪竹[1] 童建东[1] 

机构地区：[1]扬州市第一人民医院肿瘤科,225009

出　　处：《中国实用医药》2014年第34期7-8,共2页China Practical Medicine

摘　　要：目的探讨经左胸食管癌根治术后复发进展模式,以及在三维治疗条件下该术式术后放射治疗布野设计。方法 96例经病理确诊的食管癌根治术后复发进展患者,所有患者均为行经左胸食管癌根治术、R0切除。术后分期按AJCC第7版分期标准分期。回顾分析患者复发进展具体情况。结果 96例食管癌术后进展患者中,出现隆突以上进展、隆突以下进展、远处转移及复合进展患者分别占53.1%、13.5%、22.9%和10.4%,以隆突以上进展者最多。对术后给予放疗或放化疗联合治疗患者分层分析,出现隆突以上进展者仅占37.1%。而对于术后未予放疗患者,隆突以上进展者高达63.8%。结论食管癌术后进展情况以局部复发转移为主,对于术后考虑放疗患者,给予术后上纵隔联合锁骨上野预防照射,有可能带来局部控制获益,尤其对胸中上段患者可考虑给予淋巴引流区预防照射。Objective To investigate the relapse pattern after radical surgery for left thoracic esophageal carcinoma, and the radiotherapy field design with three dimensional treatment after the radical surgery. Methods A total of 96 diagnosed esophageal cancer patients with postoperative relapse were enrolled, and they all underwent radical surgery for left thoracic esophageal carcinoma and R0 resection. AJCC standard version 7 was used for postoperative stage. The relapse progress was retrospectively analyzed. Results Among the 96 patients, the cases with progress above the carina, progress under the carina, distant metastasis, and complex progress respectively accounted for 53.1%, 13.5%, 22.9% and 10.4%, and the number of progress above the carina was the most. Stratified analysis was made on cases received radiotherapy or Chemoradiotherapy, and there were 37.1% of the patients with progress above the carina. While there were 63.8% of the patients, who received no chemoradiotherapy, with progress above the carina. Conclusion Postoperative progression of esophageal cancer mainly occurs through local relapse and metastasis. Postoperative irradiation of mediastinal and joint supra clavicular area may bring benefit for patients, especially for those received chemoradiotherapy. The preventive irradiation of lymphatic drainage area can be considered for patients with cancer in thoracic upper middle section.

关 键 词：食管癌 左胸食管癌根治术 放疗 复发 

分 类 号：R735.1[医药卫生—肿瘤]