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目的比较术前放疗与术后放疗对中晚期食管癌预后的影响。方法 95例中晚期食管癌分为术前放疗(A组,45例)和术后放疗(B组,50例)两组。随访5年,用Kaplan-Merier法计算生存率。结果 A组和B组1年和3年生存率相仿(95.8%vs.90.0%和77.8%vs.62.0%)(P>0.05);A组5年生存率明显大于B组(62.2%vs.34.0%)(P<0.05)。淋巴结阳性的患者5年生存率明显大于淋巴结阴性患者(55.0%vs.15.4%)(P<0.05)。肿瘤长度>5 cm患者5年生存率明显大于≤5 cm患者(66.7%vs.32.2%)(P<0.05)。肿瘤外侵(+)患者5年生存率明显大于外侵(-)患者(52.6%vs.13.0%)(P<0.05)。结论与术后放疗相比,术前放疗能显著的提高中晚期食管癌患者5年生存率。对于肿瘤长度>5 cm、有外侵和有淋巴结转移的中晚期食管癌患者宜常规在根治术前行放射治疗。
Objective To compare the effects of preoperative radiotherapy and postoperative radiotherapy on the prognosis of advanced esophageal cancer. Methods 95 cases of advanced esophageal cancer were divided into two groups: preoperative radiotherapy (group A, 45 cases) and postoperative radiotherapy (group B, 50 cases). After 5 years of follow-up, Kaplan-Merier method was used to calculate the survival rate. Results The 1-year and 3-year survival rates in groups A and B were similar (95.8% vs.90.0% vs 77.8% vs.62.0%, P> 0.05). The 5-year survival rate in group A was significantly higher than that in group B (62.2% vs. 34.0%) (P <0.05). The 5-year survival rate of lymph node-positive patients was significantly higher than that of node-negative patients (55.0% vs.15.4%) (P <0.05). The 5-year survival rate of patients with tumor length> 5 cm was significantly greater than that of patients ≤5 cm (66.7% vs.32.2%) (P <0.05). The 5-year survival rate was significantly higher in patients with tumor invasion (+) than in patients with invasion (52.6% vs.13.0%) (P <0.05). Conclusion Compared with postoperative radiotherapy, preoperative radiotherapy can significantly improve the 5-year survival rate of patients with advanced esophageal cancer. For tumor length> 5 cm, patients with advanced esophageal cancer who have invasion and lymph node metastasis should routinely perform radiotherapy before radical surgery.