食管癌术后锁骨上淋巴结转移挽救性放疗的临床价值探讨

Clinical value of salvage radiotherapy for supraclavicnlar lymph node metastasis after esophageal cancer operation

目的探讨食管癌术后锁骨上淋巴结转移挽救性放疗的临床价值。方法选择2014年11月至2017年2月本院收治的晚期食管癌颈部淋巴结转移患者83例，随机数字法分为两组，观察组42例，对照组41例，对照组实施单纯化疗，观察组在对照组基础上行挽救性放疗，比较干预后两组患者机体免疫球蛋白水平变化，了解两组干预前后生活质量及颈部肿块大小变化情况。结果干预后，观察组IgM、IgG、IgA水平均高于对照组（P〈0．05）；干预前两组生活质量评分比较差异无统计学意义（P〉0．05），干预后观察组患者生活质量得分优于对照组（P〈0．05）；干预前两组颈部肿块大小比较差异无统计学意义（P〉0．05），干预后观察组颈部肿块显著小于对照组（P〈0．05）。结论针对食管癌颈部淋巴结转移者实施三维适形放疗，对提高患者免疫功能，改善生活质量，缩小肿块面积有重要价值。

Objective To investigate the clinical value of salvage radiotherapy for supraclavicular lymph node metastasis after esophageal cancer operation. Methods 83 patients with advanced esophageal cancer and cervical lymph node metastasis in our hospital were enrolled in this study from November 2014 to February 2017. The patients were divided into two groups： observation group （n=42） and control group （n=41） with the random number table method. The control group was treated with chemotherapy alone, and the observation group was treated with salvage radiotherapy on the basis of the control group. Compared the level of immunoglobulin after the intervention of the two groups, understood the quality of life and neck mass volume before and after the intervention of the two groups. Results After the intervention, the levels of IgM, IgG, and IgA in the observation group were higher than those in the control group （P〈0.05）. There was no statistically significant difference in the quality of life score between the two groups before treatment （P〉0.05）; after the intervention, the quality of life score in the observation group was better than that in the control group （P〈0.05）. There was no statistically significant difference in the neck mass volume between the two groups before treatment （P〉0.05）; after the intervention, the neck mass volume in the observation group was less than that in the control group （P〈0.05）. Conclusion Three - dimensional conformal radiotherapy for esophageal cancer patients with cervical lymph node metastasis is of great value in improving the immune function and the quality of life, and reducing the volume of the tumor.