食管癌调强放疗后照射野内复发的临床研究

Clinical study of recurrence of esophageal cancer in radiation field after IMRT

目的研究食管癌调强放疗后照射野内复发的特点。方法回顾性分析2009年1月至2013年1月放疗科诊治的39例食管癌调强放疗后照射野内复发患者的临床资料,分析该组患者的复发特点。结果照射野内复发中,锁骨上淋巴结复发占25.6%,纵隔淋巴结复发占5.1%,食管肿瘤复发占74.4%。食管肿瘤复发时间多因素方差分析,首次放疗前CT提示食管肿瘤有无外周侵犯(F=6.7,P=0.025)、放疗中有无加入化疗的复发时间比较差异有统计学意义(F=7.022,P=0.022)。结论目前调强放疗治疗食管癌照射野内复发仍以食管肿瘤为主,但是锁骨上淋巴结复发率较高,应引起临床重视。

Objective to study the features of recurrence of esophageaL cancer in radiation fieLd after IMRt. Methods the cLinicaL data of 39 patients which had recurrence of esophageaL cancer in radiation fieLd after IMRt were retrospectiveLy anaLyzed the patients accepted the treatment from January 2009 to January 2013. the features of recurrence were anaLyzed. Results In terms of recurrence of esophageaL cancer in radiation fieLd,the recurrence rate of supracLavicuLar Lymph node was 25. 6%,the re-currence rate of mediastinaL Lymph nodes 5. 1%,the recurrence rate of esophageaL neopLasm 74. 4%,and the recurrence of e-sophageaL cancer was determined by muLtivariate anaLysis of variance. there was significant difference in the vioLation of the outer periphery of esophageaL cancer or not（F=6. 7,p=0. 025）,and there shouLd be Ct before the first radiotherapy. there was significant difference in the recurrence between radiochemicaL therapy and radiotherapy（F=7. 002,p=0. 002）. Conclusion Recurrence mainLy occurred on the tumors of esophagus,in the radiate reasonabLe fieLd of IMRt treatment for esophageaL cancer, but high recurrence rate of supracLavicuLar Lymph node shouLd be paid attention.