胸段食管癌术后纵隔转移灶常规分割联合立体定向放射治疗的疗效观察

Observation of the effect of conventional fractionated radiotherapy combined with three-dimensional radiotherapy for mediastinal metastasis from postoperative esophageal carcinoma

目的观察胸段食管癌根治术后纵隔淋巴结转移常规分割联合三维适形放射治疗的意义和效果。方法34例食管癌术后纵隔淋巴结转移患者，接受常规分割照射20～30Gy／10—15Fx后，行三维适形放射治疗，2．0Gy／次，5次／周，照射总剂量64～66Gy。评价近期疗效、毒副作用和生存率。结果治疗后1个月行cT或MRI复查，病灶达完全缓解（CR）13例，部分缓解（PR）18例，稳定（sD）3例，总有效率91．2％（31／34）。治疗后3个月行cT或MRI复查，病灶达CR21例，PR12例，SD1例，有效率97．0％（33／34）。1、2、3年生存率分别为76．5％、41．2％、17．5％。主要毒副作用可以耐受。结论胸段食管癌根治术后纵隔淋巴结转移常规分割联合三维适形放射治疗可以明显提高局部控制率和生存率，毒副作用可以耐受。

Objective To evaluate the effect of conventional fractionated radiotherapy combined with three- dimensional radiotherapy for mediastinal metastasis from postoperative esophageal carcinoma. Methods A total of 34 patients were treated with conventional fractionated radiotherapy（20 ~ 30Gy/10 ~ 15Fx） combined with three-dimen- sional radiotherapy with a total dose of 64 - 66Gy. Short-term effect, acute adverse reaction and survival were evalua- ted. Resdts After treatment for one month,the CR, PR, SD were 13 cases, 18 eases and 3 cases, respectively, the to- tal effective rate was 91.2% （31/34）. After treatment for three months,the CR, PR, SD were 21 cases, 12 cases and 1 case,respectively,the total effective rate was 97.0% （33/34）. The 1-year, 2-year and 3-year survival rate were 76. 5% ,41.2% , 17.5%. The major adverse effect could be tolerated. Conclusion Conventional fractionated radio- therapy combined with three dimensional radiotherapy can enhance the local control rate and survival rate of mediasti- nal metastasis from postoperative esophageal carcinoma.