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目的研究食管癌调强放疗后照射野内复发的特点。方法回顾性分析2009年1月至2013年1月放疗科诊治的39例食管癌调强放疗后照射野内复发患者的临床资料,分析该组患者的复发特点。结果照射野内复发中,锁骨上淋巴结复发占25.6%,纵隔淋巴结复发占5.1%,食管肿瘤复发占74.4%。食管肿瘤复发时间多因素方差分析,首次放疗前CT提示食管肿瘤有无外周侵犯(F=6.7,P=0.025)、放疗中有无加入化疗的复发时间比较差异有统计学意义(F=7.022,P=0.022)。结论目前调强放疗治疗食管癌照射野内复发仍以食管肿瘤为主,但是锁骨上淋巴结复发率较高,应引起临床重视。
Objective To study the characteristics of recurrence in radiation field after esophageal cancer intensity modulated radiotherapy. Methods The clinical data of 39 patients with recurrent esophageal cancer after radiotherapy for intensity-modulated radiotherapy from January 2009 to January 2013 were retrospectively analyzed. The recurrence characteristics of this group of patients were analyzed. Results During recurrence in the field, recurrence of supraclavicular lymph nodes accounted for 25.6%, recurrence of mediastinal lymph nodes accounted for 5.1%, and recurrence of esophageal cancer accounted for 74.4%. Multivariate analysis of variance of esophageal cancer recurrence time, CT before the first radiotherapy showed whether there was peripheral invasion of esophageal cancer (F=6.7, P=0.025), there was a significant difference in the time of relapse between chemotherapy and radiotherapy (F=7.022, P=0.022). Conclusions Intensity-modulated radiotherapy for esophageal cancer recurrence in the field is still dominated by esophageal tumors, but the rate of recurrence of supraclavicular lymph nodes is high and should be given clinical attention.