根治性放疗后食管癌复发的手术切除和再程放疗的比较

Comparision between operation and secondary radiotherapy for recurrent esophageal carcinoma after radical radiotherapy

目的 :分析比较食管癌根治性放疗 (DT6 0～ 70 Gy/ 6～ 7周 )后复发的患者经手术切除和再程放疗的疗效。材料与方法 :1984年 1月～ 1990年 1月间将前瞻性随机分组的 78例患者随机分为手术切除组和再程放疗组进行对比治疗。手术切除组 39例 ,再程放疗组 39例 ,放疗剂量 DT4 0～ 6 0 Gy/ 4～ 6周。结果 :手术切除率为 89.7% ,手术切除组术后并发症为 2 5 .7% ,手术死亡率达 11.4 %。 1,3,5年生存率分别为 82 .8%、34.5 %和 2 7.6 % ;再程放疗组 1,3,5年生存率分别为 4 0 .5 %、8.1%和 2 .7% ,两组比较(P<0 .0 1)。结论 :手术切除组的疗效明显好于再程放疗组 ,手术是根治性放疗后复发患者首选的治疗手段。

Purpose:To compare the treatmentresults between operation and secondary radiothera- py for recurrent esophageal carcinoma after radical radiotherapy.Materials and Methods:78patients with recurrent esophageal carcinoma after radical radiotherapy (radiation dose was 6 0～ 70 Gy/ 7wks) were randomly divided into two groups (operation in 39and secondary radiotherapy in 39patients) from January,1984 to January,1990 .The radiation dose of the second radiotherapy was 4 0～ 6 0 Gy.Results: The resectrate was 89.7% ,complication rate was 2 5 .7% and operation mortality was 11.4 % in opera- tion group.The 1- ,3- ,5 - year survival rates were 82 .8% ,34.5 % and 2 7.6 % in operation group but only 4 0 .5 % ,8.1% and 2 .7% in second radiotherapy group(P<0 .0 5 ) .Conclusion:Operation is the first choice for patients with recurrent esophageal carcinoma after radical radiotherapy.