食管癌单纯手术与术后放疗的对比观察

A Comparative Study of Operation Only and Operation with Postoperative Irradiation in Esophageal Cancer

作者为阐明食管癌术后放疗的效果，将１９８５～１９８９年期间８２例食管癌术后预防性放疗病人与同期９８２例单纯手术病人进行对比观察。手术采用食管次全切除加食管周围脂肪组织和淋巴结、以及贲门、胃左淋巴结切除。放疗在术后２～６周开始，剂量为纵隔区５０～６０Ｇｙ／５～６周，双锁骨上区５０Ｇｙ／５周。结果表明，Ⅱａ期术后放疗病人５年生存率为４２．０％，单纯手术组为２６．０％（Ｐ＜０．０１）。Ⅲ期病人的５年生存率两组无差异（Ｐ＞０．０５），但术后放疗组逐年生存率略高于单纯手术组。结果提示，除０期病人外，食管癌术后均应进行放疗。

In order to clarify the effect of radiation therapy following resection of esophageal carcinoma,a comparative study was done between the group of 82 patients treated by this method and the group of 982 patients treated by operation only during l985 to l989.The operation was subtotal resection of esophagus with additional resections of paraesophageal fat tisstie and l ymph nodes,and lymph nodes around the gastric cardia and left gastric lymph nodes.Radiation therapy began at from 3rd to 6th weeks after operation and the dose was 50￣ 60 Gy/5￣6W in mediastinal region,50 Gy/5W in supraclavicular areas,The results showed that 5- year survival rate of the patients treated by operation with postoperative radiothrapy and by operation only were 42.0% and 26.0%(P<0.0l)respectively in stage IIa.Of the patients in stage Ⅲthe postoperative survival rate was little higher in the group of patients treated by operation with postoperative radiotherapy than in the patients treated by operation only.but there was no significant difference between the two groups(P>0.05).It is suggested that postoperative radiotherapy should be carried out in all patients with esophaged cancer in the any stages except the patients in stage 0.