摘要
目的:探讨全量调强放疗未控食管下段鳞癌再行手术治疗的相关问题。方法:回顾性分析43例(A组)调强放疗未控食管下段鳞癌患者再行手术治疗的临床资料,与310例(B组)食管下段鳞癌常规手术资料对比,并与50例调强放疗未控食管下段鳞癌接受姑息性治疗的患者(C组)临床资料进行比较。结果:A、B组术中出血、手术时间、切除率等及术后并发症发生率等方面比较差异均无统计学意义(P>0.05);B组1、2年生存率优于A组(P<0.05);C组1、2、3年生存率均明显低于A、B组(P<0.01)。结论:调强放疗具有放射野精确、周围组织损伤小的优点,调强放疗后短期未控食管下段鳞癌患者再行手术治疗手术的可行性、安全性仍然较好,且有较保守、姑息性治疗更好的生存受益,严格病例筛选前提下,并认真科学做好围术期处理,可积极开展此类手术。
Objective： To explore related problem of surgical procedure for uncontrolled esophageal carcinoma after curative intensity modulated radiotherapy.Method： Retrospect eontrastive analyzed these clinical data of lower thoracic segment esophageal squamous cell carcinoma, 43 patients （ A group ） with uncontrolled esophageal carcinoma after curative intensity modulated radiotherapy, 310 cases （ B group ） of esophageal carcinoma were treated with conventional operation, 50 cases （ C group ） with uncontrolled esophageal carcinoma after curative intensity modulated radiotherapy were treated with palliative care.Result： Compared A group with B group, the differences were not statistically significant in intraoperative blood loss, average operating time, surgical resection surgical complications, or other aspects （P〉0.05） .But, the 1 and 2 years survival rate in B group were better than A group （ P〈0.05 ） ; 1, 2, and 3 years survival rate in C group were quite lower than A and B group （P〈0.01） .Conclusion： Curative intensity modulated radiotherapy has advantages as more accurate radiation field and less surrounding tissue damage, surgical operation for uncontrolled esophageal squamous cell carcinoma after curative intensity modulated radiotherapy has pretty good operation feasibility and safety, meanwhile, operation may bring better survival benefit to those patients treated with palliative care.So, we can actively carry out such an operation on the condition of strictly screening cases and serious scientific perioperative management.
出处
《中国医学创新》
CAS
2017年第4期26-30,共5页
Medical Innovation of China
基金
山东省泰安市科技发展计划项目(2016NS1182)
关键词
食管肿瘤
鳞状上皮癌
放射治疗
未控/复发
手术治疗
预后
Esophageal neoplasms
Squamous cell carcinomas
Radiation therapy
Uncontrolled/ recurrence
Surgical treatment
Prognosis
