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目的探讨术前放射治疗在局部晚期食管癌综合治疗中的应用价值。方法收集安阳市肿瘤医院2008年8月至2010年2月收治的局部晚期食管癌行术前放疗患者30例(R+S组);随机抽取同期行单纯手术治疗的Ⅱb～Ⅲ期食管癌患者40例(S组)。根据术后病理报告对食管旁淋巴结转移率,手术并发症,1、3年生存率进行对比分析。结果 R+S组食管旁淋巴结转移率为23.3%,手术并发症发生率为60.0%,1年生存率为80.3%,3年生存率为26.7%;S组食管旁淋巴结转移率为65.0%,手术并发症发生率为32.5%,1年生存率为70.0%,3年生存率为17.5%。结论术前放疗对于局部晚期食管癌不能手术切除的患者是行之有效的方法,提高切除率,减少照射野内淋巴结转移率,延长放疗后重度病理反应及无癌者的1、3年生存率;但手术并发症增加,平均手术住院日延长;食管癌的治疗应遵循个体化原则。
Objective To investigate the value of preoperative radiotherapy in the treatment of locally advanced esophageal cancer. Methods Thirty patients (R + S group) with preoperative radiotherapy of locally advanced esophageal cancer who were treated in Anyang Cancer Hospital from August 2008 to February 2010 were enrolled. Patients with stage Ⅱb-Ⅲ esophageal cancer 40 cases (S group). According to the postoperative pathological report, the metastasis rate of esophageal lymph nodes, surgical complications, and 1,3-year survival rates were compared. Results The rate of esophageal lymph node metastasis was 23.3% in R + S group, the incidence of surgical complications was 60.0%, the 1-year survival rate was 80.3%, and the 3-year survival rate was 26.7%. The rate of paraesophageal lymph node metastasis in S group was 65.0% The incidence of surgical complications was 32.5%, the 1-year survival rate was 70.0%, and the 3-year survival rate was 17.5%. Conclusions Preoperative radiotherapy is an effective method for patients with locally advanced esophageal cancer who can not be surgically removed to improve the resection rate, reduce the rate of lymph node metastasis and prolong the one to three year survival rate after radiotherapy. However, surgical complications increased, the average length of hospital stay; esophageal cancer treatment should follow the principle of individualism.