摘要
目的探讨食管癌术后局部复发转移的放疗效果。方法回顾性分析食管癌术后局部复发转移行放疗的60例患者临床资料，单纯吻合口复发8例，吻合口复发＋纵隔淋巴结转移21例，腹腔淋巴结转移5例，单纯锁骨上淋巴结转移9例，单纯纵隔淋巴结转移11例，锁骨上区＋纵隔淋巴结转移6例。所有患者均采用三维适形放疗，剂量50～70Gy。观察放疗后的近期疗效、生存率及急性放射不良’反应。结果患者近期总有效率为78．3％。1、2、3年生存率分别为100％、50．O％、30．O％，中位生存期为15．8个月。急性放射不良反应包括：急性放射性食管炎Ⅰ、Ⅱ级16例（26．7％，16／60），Ⅲ级4例（6．7％，4／60）；急性放射性肺炎11例（18．3％，11／60）；骨髓抑制Ⅰ、Ⅱ级3例（5％，3／60）；急性心脏损伤1例（1．7％，1／60）。结论食管癌术后局部复发行三维适形放疗是一种疗效较好的治疗方法，缩短了放疗疗程，提高了生存率。
Objective To investigate the effects of radiotherapy of patients with post-operative loco- regional recurrence of esophageal carcinoma. Methods Retrospectively analyzed the clinical data of 60 patients with esophageal carcinoma who developed post-operative loco-regional recurrence. There were 8 patients with anastomosis relapse,21 with anastomosis and mediastinal lymph nodes metastasis,5 with abdominal lymph node metastasis,9 with supra clavicular lymph node metastasis, 11 with mediastinal lymph node metastasis and 6 with mediastinal and supra-clavicular lynph node metastasis. Three-dimensional conformal radiation therapy was used to treat all the patients, with a total radiation dose of 50 -70 Gy. Short-term effect, survival and adverse reactions of acute radiation were observed after radiotherapy. Results The effective rate of short term was 78. 3%. The 1 st,2nd and 3th year overall survival rates were 100%, 50. 0%, 30.0%, respectively, and the middle survival phase was 15.8 months. Acute radiation side effects include： 16 cases of acute radiation esophagitis grade I , II （26. 7% ,16/60） ,4 cases of III grade （6. 7% ,4/60） ; 11 cases of acute radiation pneumonitis （ 18. 3%, 11/60） ;3 cases of bone marrow suppression I , II grade （5% ,3/60） and acute cardiac injury in 1 case （1.7%, 1/60）. Conclusion Radiotherapy may improve the survival rate and the reduce the therapy phase of esophageal carcinoma patients with postoperative recurrence which is a good method for patients.
出处
《中国综合临床》
2013年第8期869-871,共3页
Clinical Medicine of China
关键词
食管癌
肿瘤复发
三维适形放疗
Esophageal carcinoma
Neoplasm recurrence
Three dimensional conformal radiotherapy
