术前放疗提高中晚期食管癌生存率随访结果报道

The 15-30 Years Follow-up for the Effect of Preoperative Radiotherapy on the Survival of middle and late-staged Esophageal Carcinoma

目的:研究随机化60Coγ线术前放疗提高食管癌远期生存率的效果。方法:运用生存分析的寿命表法和Kaplan-Meier法对比分析了本院1972～1986年经随机抽签决定的336例术前放疗和1680例单纯手术患者随访15～30年的资料。结果:发现术前放疗能显著提高中晚期食管癌5、10、15年生存率;术后15年内术前放疗与单纯手术者相比生存曲线位置显著提高(P=0.001);分组分析发现Ⅱa期食管癌术前放疗后分期下降者比分期不变者生存曲线位置显著提高(P<0.04);术前放疗对中段食管癌、根治切除者提高远期生存率效果显著。结论:60Coγ线术前放疗能提高中晚期食管癌的远期生存率,应该在临床上推广应用。

Objective: To confirm the long term survival improvement by 60Coγ preoperative radiotherapy on middle and late-staged esophageal carcinoma cases. Methods: Life table and Kaplan-Meier survival analysis were adopted for the follow up data, within 16 to 30 years, in the 336 randomly allocated pre-radiotherapied and 1680 simple surgery esophageal cases to compare the survival differences. Results: Significant differences were found in the 5?10 and 15 year survival rates between the two case groups. The preradiotherapied group has a significantly elevated survival curve than the simple surgery group for 1-15 years after operation (P=0.001); significant differences in favor of pre-radiotherapy were found in the subgroups of pre-and post-radiational stage decreased Ⅱa cases, middle segment esophageal carcinoma, completely resected cases. Conclusions: 60Coγ Preradiotherapy improves the long term survival of middle and late-staged esophageal carcinoma cases. Pre-radiotherapy should be considered as a routine practice for middle and late-staged esophageal carcinoma cases.