120例超长食管癌放射治疗疗效分析

Analysis of radiotherapeutic effects for 120 patients with extra long esophageal carcinoma

目的 :探讨超长食管癌放射治疗的价值及影响预后因素。方法 :1985年 3月～ 1992年 12月收治超长食管癌 12 0例 ,均采用60 Co外照射 ,DT60～ 70Gy。结果 :治疗后的 1、3、5年生存率分别为 30 %、6.7%、5.8% ;病变 <11cm和≥ 11cm的 5年生存率分别为 7%、0 ;疗终X线表现基本消失与部分消失的 5年生存率分别为 13.7%、0 (P <0 .0 5) ;超长食管癌的锁骨上淋巴结转移率 2 4 .2 % ,明显高于同期食管癌锁骨上淋巴结转移率 13.5% (P <0 .0 1)。结论 :超长食管癌应积极治疗 ,食管癌锁骨上淋巴结转移率及远处转移率与病灶长度呈正相关 ,食管病灶长度、疗终X线表现。

Objective:To evaluate the value of the radiotherapy for the patients with extra long esophageal carcinoma and the prognostic factors.Methods:120 Patients with extra long esophageal carcinoma were treated by 60 Co external irradiation at the dose of 60～70 Gy for the esophagus.Results:The 1year,3year,5year survival rate was 30%、6.7% and 5.8% respectively.The 5year survival rates for the lesion length<11cm was 7% and ≥11cm was 7% and 0,The 5year survival rate for complete disappearance and for partial disappearance on X-ray films after radiotherapy were 13.7% and 0(P<005).For supraclavicular lymphadenopatly, the metastasis rate of extra long esophageal carcinoma (24.2%) was significanly higher than that of esophageal carcinoma of the same stage (13.5%),P<0.01. Conclusions:The extra long esophageal carcinoma should be treated actively.The supraclavicular lymphatic metastasis rate and distant metastasis rate were corresponded to the lesion length.The lesion length,Xray manifestation after radiotherapy and dose of irradiation are the main prognostic factors.