食管癌术后纵隔转移灶的放射治疗

Radiotherapy of mediastinal metastasis after radical operation in esophageal carcinoma

目的 探讨胸段食管癌根治术后纵隔转移灶放射治疗的意义和效果。方法 回顾性分析 76例食管癌根治术后 3～ 18个月发生纵隔转移患者。转移灶 <2cm 11例 ,2～ 3cm 33例 ,>3cm 32例。伴有颈淋巴结转移 9例 ,伴脏器转移 3例。放射治疗采用60 Co常规分割照射 ,照射剂量10 .8～ 75 .0Gy。结果 未完成治疗计划的 9例患者均于照射后 1年内死亡。照射剂量为 5 0～ 75Gy患者 1、2、3年生存率分别为 75 .0 % (5 7/ 76 )、2 7.6 % (2 1/ 76 )和 9.2 % (7/ 76 )。结论 食管癌根治术后发生纵隔转移进行放射治疗可以延长患者生存时间 ,照射剂量以组织量 6 5～

Objective To study the significance of radiotherapy of mediastinal metastasis after radical surgery for thoracic esophageal carcinoma. Methods Seventy six patients with esophageal carcinoma who developed mediastinal metastasis 3～18 months after radical surgery were retrospectively analyzed. The size of mediastinal metastasis was <2?cm in 11 patients, 2～3?cm in 33 and >3?cm in 32. Nine of these patients had metastasis in neck lymph nodes and 3 had distant metastasis as well. Radiotherapy was given with a Cobalt 60 unit. The radiation dose ranged from 10.8?Gy to 75.0?Gy by conventional fractionation. Results Nine patients did not finish radiotherapy and all of them died within one year of (after) treatment. The mean of survival time was 4.9 months. Sixty seven patients received radiation of 50～70?Gy. The corresponding overall survivals at 1, 2, and 3 years were 75.0% (57/76), 27.6% (21/76) and 9.2% (7/76), respectively. Conclusion Radical radiotherapy may improve the prognosis with an appropriate tumor dose of 65～75?Gy.