分析食管癌根治性放疗后复发模式确定是否选择性淋巴结照射

Analysis patterns of recurrence after definitive radiotherapy to determine whether elective nodal irradiation for of esophageal carcinoma

目的研究胸段食管癌放射治疗选择性淋巴结照射(ENI)的有效性。方法回顾分析我院2006年4月至2009年2月期间新就诊的胸段食管鳞癌患者,80例患者均进行选择性淋巴结照射,选择性淋巴结照射剂量50Gy,原发肿瘤区照射剂量60～70 Gy。结果 80例患者均耐受放射治疗,未出现严重毒副反应,60例患者达到完全缓解,获得完全缓解的患者,仅一例出现选择性淋巴结照射失败而没有其他部位复发。结论胸段食管鳞癌放射治疗的患者,淋巴结预防照射是预防淋巴结失败的有效手段,远期生存有待于进一步评估。

Objective To study the efficacy of elective nodal irradiation（ENI） in definitive radiotherapy for thoracic esophageal cancer.Methods Analyzed retrospectively patients with squamous cell carcinoma of the thoracic esophagus newly diagnosed between April 2006 and February 2009 in our hospital.Eighty patients were included in this analysis,50Gy radiation therapy was delivered to ENI,60-70Gy radiation therapy was delivered to the primary tumor.Results Eighty patients tolerated the irradiation well,and no serious acute toxicity was observed.Sixty patients achieved complete response（CR）. After achieving CR,only one patient experienced elective nodal failure without any other site of recurrence.Conclusions In RT for esophageal squamous cell carcinoma,ENI is effective for preventing regional nodal failure.Further evaluation of whether ENI leads to an improved overall survival is needed.