进展期食管癌112例根治术后的放射治疗

Radiotherapy after Curative Resection for 112 Patients with Advanced Esophageal Carinoma

目的:探讨进展期食管癌根治术后放射治疗的疗效。方法:回顾性分析112例进展期食管癌根治性切除术后进行放射治疗的患者,其中34例单纯放疗,40例序贯放化疗(化疗用PF方案2～4周期),38例同步放化疗:化疗用优福定口服,每次4片(0.648g),每日3次,连续2～4周。放疗全纵隔野采用15MV-X线,DT50～60Gy/25～30次。锁骨上野为6MV-X线,Dm50Gy/22～23次。结果:全组1、3、5年总生存率分别为77.7%、45.5%、25.9%。术后单纯放疗组、术后序贯放疗组与术后同步化疗组在放疗毒副反应和1、3、5年无复发生存率(P=2.423)及总生存率(P=2.867)等方面差异无统计学意义。结论:术后序贯放化疗和同步放化疗较单纯放疗在局控和长期生存方面无明显优势,化疗方案有待进一步改进。

Objective:To evaluate the therapeutic effect of prophylactic radiotherapy in advanced esophageal carcinoma after surgery.Methods:One hundred and twelve esophageal carcinoma cases who received postoperative prophylactic radiotherapy was analysised retrospectively,among which 34 cases,40 cases and 38 cases were treated with RT alone,S-RCT and C-RCT respectively.Tegafur was precribled while radiotherapy in C-RCT group.The radiation portals encompass the whole mediastinum and bilateral supraclavicular areas.A mid-plane dose of 50~60Gy in 25~30 fractions over 5~6 weeks or 50Gy in 22~23 fractions was delivered.Results:The overall 1,3,5-year survival rate was 77.7%,45.5%,and 25.9%,respectively.No significant difference was got among the three groups with overall survival rate,recurrence-free survival rate or complication of therapy.Conclusion:Compared with radiotherapy alone,sequential radiotherapy plus chemotherapy concurrent chemoradiotherapy and isn’t able to improve the survival rate or reduce the incidence of failure of esophageal carcinoma after surgery,therefore,the chemotherapy program must be improved.