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目的评价食管癌术后放射治疗疗效及预后因素。方法对资料完整的262例食管癌术后患者进行回顾性研究,其中单纯根治性手术133例,术后放射治疗129例,总剂量50Gy。结果随访5年。单纯手术组5年生存率为40.9%,术后放射治疗组5年生存率为60.1%。二组比较差异有统计学意义(P<0.01)。其中预后因素与T分期、N分期有关,浸润深度局限于黏膜下层以及无淋巴结转移的5年生存率,单纯手术组与术后放疗组差异无统计学意义。病灶浸润至肌层或全层以及有淋巴结转移的术后放疗组5年生存率明显高于单纯手术组(P<0.05)。与大小野照射无明显相关。结论食管癌术后放射治疗可以增加局部控制率,提高远期生存率。特别对病灶浸润至肌层或全层以及有淋巴结转移的患者有意义。
Objective To evaluate the efficacy and prognosis of postoperative radiotherapy for esophageal cancer. Methods A retrospective study was performed on 262 postoperative patients with complete esophageal carcinoma, of whom 133 cases were treated by simple radical operation and 129 cases were treated by radiotherapy after operation. The total dose was 50 Gy. The results were followed up for 5 years. The 5-year survival rate was 40.9% in the simple operation group and 60.1% in the radiotherapy group. The difference between the two groups was statistically significant (P <0.01). The prognostic factors were related to T stage and N stage. The depth of infiltration was limited to the 5-year survival rate of submucosa and no lymph node metastasis. There was no significant difference between the surgery group and the postoperative radiotherapy group. The 5-year survival rate of the patients who were infiltrated into the myometrium or the whole layer and the postoperative radiotherapy with lymph node metastasis was significantly higher than that of the simple operation group (P <0.05). No significant correlation with the size of wild irradiation. Conclusion Postoperative radiotherapy of esophageal cancer can increase the local control rate and improve the long-term survival rate. Especially for the infiltration of lesions to the myometrium or full-thickness and lymph node metastasis of patients with meaning.