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目的:对胸段食管鳞癌三野根治术患者的不同淋巴结转移个数与术后放疗的疗效进行分析,评价胸段食管鳞癌术后放疗价值。方法:收集1993-01-01-2007-03-30福建省肿瘤医院收治的胸段食管鳞癌三野淋巴结清除根治术患者1 715例,其中单纯手术1277例,术后放疗438例。术后3~4周开始放疗,中位总剂量50 Gy,2 Gy/次,5次/周,5周完成。结果:全组5年生存率为49.4%,其中淋巴结转移个数为0、1~2、3~5和>5枚的5年生存率分别为71.7%、45.0%、25.8%和11.8%,χ2=371.460,P=0.000。术后放疗与单纯手术比较可以提高淋巴结转移≥3枚患者的生存率,差异有统计学意义,χ2=10.388,P=0.001;淋巴结转移<3枚患者的生存率差异无统计学意义,χ2=1.970,P=0.160。结论:术后放疗能提高淋巴结转移≥3枚的生存率。
Objective: To evaluate the value of postoperative radiotherapy for thoracic esophageal squamous cell carcinoma by analyzing the number of different lymph node metastases and the effect of postoperative radiotherapy in patients with thoracic esophageal squamous cell carcinoma. Methods: A total of 1 715 patients with thoracic esophageal squamous cell carcinoma undergoing radical resection of the thoracic lymphadenectomy were collected from 1993-01-01-2007-03-30 at Fujian Cancer Hospital, including 1277 cases of simple operation and 438 cases of postoperative radiotherapy. Radiotherapy began 3 to 4 weeks after surgery, with a median total dose of 50 Gy, 2 Gy / time, 5 times / week and 5 weeks. Results: The overall 5-year survival rate was 49.4%. The 5-year survival rates of lymph node metastasis of 0, 1 ~ 2, 3 ~ 5 and> 5 were 71.7%, 45.0%, 25.8% and 11.8% χ2 = 371.460, P = 0.000. Postoperative radiotherapy compared with simple surgery can improve the survival rate of lymph node metastasis ≥ 3 patients, the difference was statistically significant, χ2 = 10.388, P = 0.001; lymph node metastasis <3 patients with no significant difference in survival rates, χ2 = 1.970, P = 0.160. Conclusion: Postoperative radiotherapy can improve the survival rate of lymph node metastasis ≥ 3 pieces.