食管癌术后锁骨上和纵隔淋巴结转移放射治疗的疗效评价

Radiotherapy of Supraclavicular and Mediastinal Lymph Node Metastases after Surgical Removal of Esophageal Cancer

目的 评价食管癌术后锁骨上和纵隔淋巴结转移局部放射治疗的意义。方法 回顾性分析1998年 7月～ 2 0 0 0年 2月间收治的 5 7例食管癌术后锁骨上和纵隔淋巴结转移患者 ,局部放射治疗 ,常规分割放疗剂量 5 0～ 70Gy。结果 82 .4 %左右的肿瘤得到局部控制 ,1、2、3年生存率分别为 5 6 .1%、2 9 .8%、10 .5 % ,72 .5 %的病人死于野外转移。结论 转移淋巴结≤ 3cm者放疗后的局部控制率和生存期优于淋巴结 >3cm者。食管癌术后锁骨上和纵隔淋巴结转移经放射治疗后局部可得到有效控制 ,多数病人死于远处转移。

Objective To evaluate the efficacy of radiotherapy for patients with esophageal carcinoma with supraclavicular and mediastinal lymph nodes. Methods From July 1998 to February 2000,57 cases of supraclvicular or/and mediastinal lymph node mestastases presented after resection of cancer of the esophagus were treated with irradiation.The patients received a total of 50～70Gy.Results About 82.4% of the lesions were locally controlled with irradiation. The 1,2and 3-year survivals were 56.1% , 29.8% and 10.5% respectively .Most of the patients eventually died from distant metastases. Patients with metastatic lymph nodes of ≤3cm had better local control and longer survival time than those whose nodes were >3cm in diameter.Conclusion Local irradiation is effective for control of supraclvicular and mediastinal lymph node metastases after surgery of esophageal cancer.