ⅡB～Ⅲ期食管癌根治术后预防性放疗疗效分析  

Prognosis of Stage ⅡB-Ⅲ Thoracic Esophageal Carcinoma Patients Treated with Prophylactic After Radical Esophagectomy

作　　者：宋春洋[1] 李腾[1] 赵彦[1] 许金蕊 李曙光[1] 祝淑钗[1] SONG Chunyang;LI Teng;ZHAO Yan;XU Jinrui;LI Shuguang;ZHU Shuchai(Third Division of Radiation Oncology Department, The Fourth Hospital of Hebei Medical University, Sho＇iazhuang 050011, China)

机构地区：[1]河北医科大学第四医院放三科,石家庄050011

出　　处：《肿瘤防治研究》2018年第6期404-409,共6页Cancer Research on Prevention and Treatment

摘　　要：目的探讨术后预防性放疗对ⅡB、Ⅲ期胸段食管癌根治术患者生存的影响。方法收集2007—2010年本院行食管胸段鳞癌根治术患者336例,其中ⅡB期65例、Ⅲ期271例;术后未行放疗组(S)220例,术后放疗组(S+R)116例;放疗中位剂量50 Gy。采用Kaplan-Meier法计算生存率及局控率;Log rank法检验行单因素预后分析。结果随访率为98.2%,全组患者5年生存率及5年无进展生存率分别为29.3%和25.6%;中位生存时间及中位无进展生存时间分别为26.7月和17.4月。ⅡB期患者S组与S+R组5年生存率分别为30.1%与48.6%,差异无统计学意义(χ~2=2.279,P=0.131);Ⅲ期患者S组与S+R组5年生存率分别为24.9%与32.8%,差异有统计学意义(χ~2=5.865,P=0.015);术后病理淋巴结阳性患者S组与S+R组5年生存率分别为25.9%与35.8%,差异有统计学意义(χ~2=7.663,P=0.006);全组患者S组与S+R组的中位局控时间分别为10.6和16.3月,差异有统计学意义(χ~2=6.043,P=0.014)。结论食管癌根治术后预防性放疗可明显降低局部复发并使Ⅲ期及术后病理淋巴结阳性的患者生存获益。Objective To investigate the effect of prophylactic radiotherapy after radical surgery on the longterm survival of patients with stage ⅡB-Ⅲ thoracic esophageal carcinoma. Methods We enrolled 336 stage ⅡB（n=65） and Ⅲ（n=271） thoracic esophageal carcinoma patients who underwent radical resection with（S＋R, n=116） or without（S, n=220） postoperative prophylactic radiotherapy from 2007 to 2010. The median dose of postoperative radiotherapy was 50 Gy. The Kaplan-Meier method, Log rank test and Cox model were used for survival rate calculation, univariate analysis and multivariate analysis, respectively. Results The 5-year overall survival（OS） and disease-free survival rates were 29.3% and 25.6%, respectively. The 5-year OS of stage ⅡB patients in S and S＋R groups were 30.1% and 48.6%, respectively（χ^2=2.279, P=0.131）. The 5-year OS of stage Ⅲ patients in S and S＋R groups were 24.9% and 32.8%, respectively（χ^2=5.865, P=0.015）. The 5-year OS of lymph node-positive patients in S and S＋R groups were 25.9% and 35.8%, respectively（χ^2=7.663, P=0.006）. Postoperative prophylactic radiotherapy resulted in significantly decreased intrathoracic and supraclavicular recurrence, and obviously delayed median local recurrence time in S and S＋R groups（10.6 vs. 16.3 months; χ^2=6.043, P=0.014）. Conclusion Postoperative prophylactic radiotherapy reduces local recurrence and improves the survival of stage Ⅲ or lymph node-positive thoracic esophageal carcinoma patients.

关 键 词：食管癌 术后预防性放疗 局部复发 预后 

分 类 号：R735.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]