三维适形放射治疗食管癌术后纵隔转移灶的研究

3-Dimensional Conformal Radiation Therapy of Metastasis in Mediastinum after Operation for Esophageal Carcinoma

目的:探讨三维适形放射治疗胸段食管癌根治术后纵隔转移灶的意义和效果。方法:分析56例食管癌根治术后(3～20)个月发生纵隔转移患者。转移灶直径<2cm 10例,(2～3)cm 30例,>3cm 16例,伴有颈淋巴结转移6例。56例均行三维适形放射治疗4.0 Gy次/,3次/周,照射总剂量(56～60)Gy。结果:治疗后1个月复查,病灶达CR者27例,病灶达PR者29例,无进展病例。1年、2年、3年生存率分别为82.0%、51.8%、16.0%。结论:食管癌根治术后发生纵隔转移进行三维适形放射治疗可以明显提高局部控制率和生存率,副作用小。

Objective：To evaluate the effect and its clinical significance of 3 - dimmentional conformal radiotherapy （3 -DCRT）on metastasis in mediastinum after operation for esophageal carcinoma. Methods：Data of fifty - six patients who had metastasis in medastinum after （3 ~ 20） months operation of esophageal carcinoma and were treated with 3 -DCRT （4.0Gy/time, 3/week, total radial dosage 56Gy ~ 60Gy） were reviewed. The diameter of metastasis reaches 〈 2cm（10cases） , （2 - 3 ） cm （ 30 cases） and 〉 3cm （ 16 cases）. Results： Complete response rate and partial response rate were 48.2% and 51.8% respectively after one month treatment with no progression of disease. The 1 - , 2 - and 3 - year survival rates were 82% , 51.8% and 16% respectively. Conclusions：Three - dimensional conformal radiotherapy, with lit side - effects, can markedly improve the local control rate and survival rate of patients with mediastinal metastasis from esophageal carcinoma after surgery.