中晚期食管癌术后放疗临床分析

Clinical analysis of postoperative radiotherapy for advanced esophageal carcinoma

目的:评价中晚期食管癌术后放疗的临床价值。方法:40例食管癌术后患者均采用医用电子直线加速器6MV-X线外照射进行治疗。用模拟机定位,设三野或四野,无肿瘤残留者肿瘤照射剂量为5000cGy,有肿瘤残留者肿瘤照射剂量为6000-7000cGy。锁骨上淋巴结转移灶用6MV-X线和9MeV-E线的混合线束照射治疗,肿瘤照射剂量控制在6000-7000cGyr。结果:40例患者中38例随访2-9年,1、3、5年生存率分别为67.5%、34.3%、30.0%。死亡29例,死于局部复发3例(10.3%),远处转移19例(65.5%),其它疾病2例(6.9%),原因不明5例(17.2%)。结论:食管癌术后放疗能降低局部复发率,提高5年生存率,但不能降低远处转移率。

Objective： To evaluate the clinical effect of postoperative radiotherapy for advanced esophageal carcinoma. Methods： Forty patients with esophageal carcinoma after surgery were treated by using electronic line accelerator 6MV-X line. Simutator was used for location. Three or four fields were planned. Patients without residual tumor were given 5 000 cGy and those with residual tumor were given 6 000 cGy -7 000 cGy. The 6-MV X ray or 9Mev E ray were used for the supra clavicle lymph node metastatic focus and the tumor dose was controlled within 6 000 cGy-7 000 cGy. Results. Among 40 patients, 38 patients were followed up 2-9 year . the 1, 2, 3-year survival rates were 67. 5%, 34.3%, 30. 0% respectively. Among 29 patients who had died, the causer of death 3 with local recurrence （10.3%）, 19 of far metastasis（65. 5%）, 2 died of other diseases （6.9%）, The reason for 5 patients＇ death was not clear （17.2%）. Conclusions： Radiotherapy about esophageal carcinoma after surgery can decrease partial recurrence rates and raise 5-year survival rates, but metastasis rates can not be decreased.