食管鳞癌术后放疗研究进展  

Research advances in postoperative radiotherapy for esophageal squamous cell carcinoma

作　　者：罗毅君[1,2] 李明焕[2] 朱英明[2] 于金明[2] 

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院,250022 [2]山东省肿瘤医院放疗科,济南250117

出　　处：《中华放射肿瘤学杂志》2016年第8期891-894,共4页Chinese Journal of Radiation Oncology

摘　　要：手术是局限期食管癌的重要治疗手段，但单纯手术切除的5年生存率仅20％～25％。早期研究显示术后放疗降低区域复发率，但并不能提高生存率。近期大部分研究显示Ⅲ期或淋巴结阳性患者能从术后放疗中生存获益，且pT2？3 N0 M0期患者术后放疗可能获益。放疗靶区范围推荐以双侧锁骨上区、上纵隔、隆突下以及瘤床为主，大部分研究推荐下段病变应包括上腹部区域淋巴结。对局部晚期患者术后放疗联合化疗可能带来更大获益。关于食管鳞癌术后放疗意义、靶区设计及联合化疗等问题需个体化考量，需更多的临床证据。Surgery remains an important therapeutic method for localized esophageal cancer, but the 5？year survival rate of patients undergoing surgical resection alone is only 20%？25%. Early studies show that postoperative radiotherapy reduced regional recurrence rate, but did not increase the survival rate. Most recent studies show that stage Ⅲ or lymph node？positive patients can obtain survival benefit from postoperative radiotherapy, and patients in pT2？3 N0 M0 stage may also benefit from postoperative radiotherapy. The recommended radiotherapy target volumes include bilateral supraclavicular areas, superior mediastinum, subcarinal area, and tumor bed. It is recommended in most studies that regional lymph nodes in the upper abdomen should be included in patients with lower？segment lesions. The locally advanced patients may benefit more from postoperative radiotherapy combined with chemotherapy. The significance of postoperative radiotherapy for esophageal squamous cell carcinoma, target volume design, and combined chemotherapy need individualized consideration and more clinical evidence.

关 键 词：食管肿瘤/外科学 食管肿瘤/术后放射疗法 研究进展 

分 类 号：R735.1[医药卫生—肿瘤]