食道癌根治术后放射治疗的观察研究

Radiotherapy for Esophageal Carcinoma After Radical Resection

目的 评价食道癌根治术后放射治疗的价值 方法 取我院 1985～ 1992年进行根治术后放射治疗 2 4例食管癌病人作术后放疗组 ,按该组病人的分期 ,分层随机抽取同期食管癌单纯根治术病人 2 4例作对照组。 DT5 0～ 6 0 Gy/ 5～ 7周。生存分析用 Kaplan- Meier方法计算 ,并以 L og- rank作显著性检验。结果 单纯手术组 1、3、5年生存率分别为 87.5 % (2 1/2 4) ,6 6 .7% (16 / 2 4) ,34.8% (8/ 2 3) ,术后放疗组 95 .8% (2 3/ 2 4) ,78.3% (18/ 2 3) ,5 4.5 % (12 / 2 2 ) ,(P >0 .0 5 )。单纯手术组血行转移 16 .7% (4 / 2 4) ,术后放疗组为 12 .5 % (3/ 2 4) ,两组相比较 ,无显著差异 (P >0 .0 5 )。局部 (瘤床以及局部淋巴引流区 )复发率单纯手术组为 5 8.3% (14/ 2 4) ,术后放疗组 2 5 .0 % (6 / 2 4) ,后者明显比前者低度 (P =0 .0 2 )。

objective To evaluate radiotherapy for esophageal carcinoma after radical resection. Method Between 1985 and 1992, 24 patients with esophageal carcinoma were treated by radiotherapy after radical resection (A group ) , Basing on the same period and clinical stages of A group ,24 patients without radiotherapy served as control(B group) randomly The radiation dose was DT50~60Gy/5~7w The survival rates were analyzed with Kaplan-Keier method and Log-rank test Result The 1-,3-and 5-year survival rates of A group were 95 8% (23/24),78 3%(18/23),54 5%(12/22),respectively, of B group were 87 5%(21/24),66 7%(16/24),34 8%(8/23), respectively( P>0 05) The metastases rates of A group was12 5%(3/24),of B group was 16 7%(4/24)(P>0 05) The local regional recurrence rates of A group was25 0%(6/24),of B group was 58 3%(14/24),the latter was significantly higher than the former (P=0 02) Conclusion radiotherapy for esophageal carcinoma after radical resection can reduce local regional recurrence rate