胸中段食管癌术后放疗临床疗效分析

Prognosis of postoperative radiotherapy for middle thoracic esophageal carcinoma

目的分析胸中段食管癌术后放疗疗效及影响预后的因素。方法回顾分析37例胸中段食管癌术后放疗的生存率、治疗失败部位和影响预后的因素。结果全组1、3、5年生存率分别为70.2%、34.4%、21.4%,中位生存时间23个月。T1+T2、T3期的1、3、5年生存率分别为81.8%、63.6%、42.4%和65.2%、21.7%、8.7%(P=0.046)。N0期和N1期的1、3、5年生存率分别为75.9%、33.7%、24.1%和50.0%、37.5%、18.8%(P=0.644)。II期和III期的1、3、5年生存率分别为73.3%、35.6%、25.4%和57.1%、28.6%、14.3%(P=0.457)。术后放疗失败以血行转移为主,其次为纵隔和锁骨上淋巴结转移。结论对术后分期为T3-4期及有淋巴结转移的胸中段食管癌患者行术后预防性放疗,可提高生存率。

Objective To evaluate the efficacy of postoperative radiotherapy for middle thoracic esophageal carcinoma and identify prognostic factors for such patients.Methods Thirty-seven patients underwent radiotherapy for middle thoracic esophageal carcinoma after radical esophagectomy from October 2004 to November 2007 in our hospital.The survival rate,failure reason and prognosis-influencing factors were analyzed.Results The overall 1-and 3-year survival rate was 70.2% and 34.4%,respectively.The median survival time was 23 months.The 1-and 3-year survival rate of patients in stages T1＋T2 and T3 was 81.8% and 63.6%,and 65.2% and 21.7%,respectively（P=0.046）.The 1-and 3-year survival rate of patients in stages N0 and N1 was 75.9% and 33.7%,and 50.0% and 37.5%,respectively（P=0.644）.The 1-and 3-year survival rate of patients in stages II and III was 73.3% and 35.6%,and 57.1% and 28.6%,respectively（P=0.457）.Distant metastases was the most common treatment failure reason,followed by local recurrence.Conclusion Postoperative radiotherapy should be performed for patients in stage T3-4 disease or with lymph node metastasis.