食管癌根治术后照射胃左淋巴引流区的意义

Significance of left gastric lymph drainage area radiotherapy after radical surgery of esophageal cancer

目的探讨食管癌根治术后是否需照射胃左淋巴引流区。方法按配对法分析2002年～2008年共106例食管癌根治术后行放射治疗患者的临床资料。106例中照射胃左淋巴引流区的共60例(胃左照射组),未照射胃左淋巴引流区的共46例(胃左未照组)。随访统计患者1、3、5年的生存情况。采用Kaplan-Meier法计算两组生存率并对组间差异进行Log-rank检验。对可能影响预后的性别、年龄、胃左淋巴结有无转移、区域淋巴结有无转移、T分期行单因素分析。结果胃左照射组1、3、5年总生存率及无瘤生存率分别为81.3%、63.9%、55.1%;81.3%、53.7%、47%。胃左未照组1、3、5年总生存率及无瘤生存率分别为73.8%、57.1%、45%;71.4%、38.6%、32.1%。胃左照射组中位生存时间为52.488月,胃左未照射组中位生存时间为50.875月,两组差异无统计学差异(P值=0.222)。单因素分析显示年龄、性别、胃左淋巴结有无转移、区域淋巴结有无转移及T分期对根治术后是否照射胃左淋巴引流区均无统计学意义(P均>0.05)。结论食管癌根治术后胃左淋巴引流区照射与否对生存时间无影响,可不做该区域预防性照射。

Objective To determine the significance of left gastric lymph drainage area radiothera- py after radical surgery of esophageal Cancer. Methods The clinical data of 106 such patients treated from 2002 through 2008 were reviewed by the pairing method. They were classified into two groups： group A, 60 patients given left gastric lymph drainage area radiotherapy;groupB..40 patients did not undergo radiotherapy. The overall and disease-free survival rates were calculated using the Kaplan-meier method and comparison of these groups was done with the Log-rank test. Variables were entered into a univariate analysis such as gender, age,left gastric lymph node metastasis, regional lymph nodes metastasis and T stage. Results The 1- 3- and 5-year overall and disease--free survival rates for patients in group A and group 13 were 81.3%,60.3%,55.1% ;81.3%,53.7%,47% and 73.8%,57.1%,45%;71. 4%, 38.6%, 32.1%, respectively. The median Survival time for patients in group A and group B were 52. 488 and 50. 875 months. The difference was not statistically significant （P = 0. 222）. Single factor analysis results showed that the gender, age, left gastric lymph node metastasis, regional lymph nodes metastasis and T stage were not statistically significant between the two groups. （P〉 0.05）. Conclu- sions It seems that it is unnecessary to give left gastric lymph drainage area radiotherapy after radical surgery of esophageal Cancer.