B超在食管癌双锁骨上区照射的应用价值

Clinical Exploration of Radiotherapy for Clavicular Area Where Detected Swollen Lymph Nodes by B-ultrasound in the Esophageal Carcinoma

目的 :探讨食管癌B超锁骨上区小淋巴结肿大患者 ,锁骨上区预防照射的临床价值。方法 :对入院锁骨上区未触及明显肿大淋巴结食管癌患者 ,常规行B超锁骨上区淋巴结检查。结果 :照射组 1、3年锁骨上区淋巴结转移率均低于对照组 ,分别为 8 1%、2 5 %及 13%、39 3% (P1年、P3年均 <0 0 5 ) ;两组 1、3年生存率分别为 5 2 8%、4 1 1%及 2 7 9%、19 6 % ,P1年 >0 0 5 ,P3年 <0 0 5。在锁骨上区放疗剂量方面 :高剂量组 (DT>5 0Gy) 1、3年锁骨上区淋巴结转移率均低于低剂量组 (DT<30Gy) ,分别为 6 33%、9 8%及 6 33%、19 5 % ,P1年 >0 0 5 ,P3年 <0 0 5 ;相应两组患者 1年及 3年生存率则分别为 5 9 5 %、4 6 3%及 35 4 %、2 0 7% ,P1年 >0 0 5 ,P3年 <0 0 5。结论 :在食管癌放疗患者 ,若B超检查锁骨上区有小淋巴结肿大 ,应予双锁骨上区照射 ,且照射剂量应DT>5 0Gy。

objective To explore the effect of preventive radiotherapy for swollen clavicular lymph nodes detected by the B ultrasound in carcinoma of the esphagus.Methods Routine check by B ultrasound was done for the patients of esophageal carcinoma whose clavicular areas were not found swollen lymph nodes by clinical exam.Rusults For the preventive group and the control group,the 1 and 3 year transfer rates of lymph nodes were 8 1%,13% and 25%,39.3% respectively,being statistical differences ( P 1 year, P 3 year<0 05);the 1 and 3 year survival rates of the two groups were 52 8%,41 1% and 27 9%,19 6% respectively, P 1 year>0 05, P 3 year<0 05.For the high dose group(D T>50 Gy) and the low dose group(D T<30 Gy),the patients'1 and 3 year transfer rates of lymph nodes were 6 33%,9 8% and 6 33%,19 5% respectively, P 1 year>0 05, P 3 year<0 05,and these two group patients'1 and 3 year survival rates were 59 5%,46 3% and 35 4%,20 7% respectively, P 1 year>0 05, P 3 year<0 05.Conclusions The preventive radiotherapy for clavicular area should be done for the patients of esophageal carcinoma whom were detected swollen lymph nodes by the B ultrasound,and the irradiation dosage should be larger than 50 Gy DT.