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目的 探讨食管癌根治术后不同部位复发放疗的疗效和预后影响因素。方法 回顾性分析 110例食管癌根治术后不同部位复发的病例 ,其中单纯颈部淋巴结转移 17例 ,纵隔淋巴结转移72例 ,腹部淋巴结转移 5例 ,吻合口复发 16例。放疗采用60 Co或 6MVX线 ,中位照射剂量为 6 2Gy。结果 全组放疗后 1、2、3、4年总生存率和中位生存期分别为 5 5 .4 %、30 .4 %、2 1.8%、14 .5 %和 14个月。单因素分析显示肿瘤复发部位、症状缓解情况、近期疗效、术后T分期及放疗总剂量与预后有关 ;多因素分析显示症状缓解情况和术后临床分期为独立预后因素。结论 食管癌术后复发放疗可以延长部分患者生存时间 ,手术时临床分期早以及放疗后症状缓解者预后较好。
Objective To investigate the efficacy and prognostic factors of recurrence and radiotherapy in different parts of esophageal cancer after radical operation. Methods A retrospective analysis of 110 cases of esophageal cancer recurrence after radical resection of the cases, including simple neck lymph node metastasis in 17 cases, mediastinal lymph node metastasis in 72 cases, 5 cases of abdominal lymph node metastasis, anastomotic recurrence in 16 cases. Radiotherapy using 60 Co or 6 MVX line, the median dose of 6 2Gy. Results The overall survival and median survival at 1, 2, 3 and 4 years after radiotherapy were 55.4%, 30.4%, 21.8%, 14.5% and 14 months respectively. Univariate analysis showed that tumor recurrence site, symptom relief, short-term efficacy, postoperative T stage and total radiation dose were related to prognosis. Multivariate analysis showed that symptom relief and postoperative clinical stage were independent prognostic factors. Conclusions Postoperative radiotherapy for esophageal cancer can prolong the survival time of some patients. The clinical stage of surgery and the prognosis of symptomatic relief after radiotherapy are good.