三维适形放疗食管癌术后食管气管沟淋巴结转移的疗效分析

Clinical Observation of Three Dimensional Conformal Radiaotherapy for Postoperative Recurrent or Metastatic Tracheoesophageal Groove Lymph Node in Esophageal Cancer

目的观察三维适形放疗（3DCRT）食管癌术后食管气管沟淋巴结转移的疗效及毒副反应。方法对37例食管癌术后食管气管沟淋巴结转移患者采用3DCRT,常规分割,总剂量55-70 Gy/28-35次,5-7周。结果 37例均顺利完成治疗,近期疗效为完全缓解（CR）20例,部分缓解（PR）7例,无变化（NC）5例,总有效率（CR＋PR）86.5%。1、3、5年生存率分别为94.6%（35/37）、81.1%（30/37）和56.7%（21/37）。主要毒副反应为放射性食管炎和放射性气管炎。其中放射性食管炎Ⅰ-Ⅱ级为40.5%（15/37）,Ⅲ-Ⅳ级反应为18.9%（7/37）。放射性气管炎发生率29.7%（11/37）,全部为Ⅰ-Ⅱ级。结论 3DCRT治疗食管癌术后食管气管沟淋巴结转移安全有效。

Objective To evaluate the response and the toxicites of three dimensional conformal radiotherapy（3DCRT） for postoperative recurrent or metastatic tracheoesophageal groove lymph node in esophageal cancer.Methods We retrospected 37 patients with postoperative recurrent or metastatic tracheoesophageal groove lymph node treated by 3DCRT.All the patients received 3DCRT to the dose of 60-70 Gy/28-35 fractions,5-7 weeks.Results The 37 patients all successfully completed the treatments.Complete response was observed in 20 patients,and partial response 7 patients,no change 5 patients.The overall response rate（CR＋PR）was 86.5%.The 1-,3-and 5-year survival rates were 94.6 %（35/ 37）,81.1%（30/37） and 56.7%（21/37）.The main toxicity was acute radiation esophagitis and radiation tracheitis.The acute radiation esophagitis in grade Ⅰ-Ⅱ was 40.5 %（15/37）,and 18.9%（7/37） in grade Ⅲ-Ⅳ.The all radiation tracheitis was in grade Ⅰ-Ⅱ and was 29.7 %（11/37）.Conclusion 3DCRT for postoperative recurrent or metastatic tracheoesophageal groove lymph node in esophageal cancer is safe and effective.