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目的比较食管癌根治性放疗后复发患者行手术和再放疗效果。方法食管癌根治性放疗后复发患者57例中,手术治疗23例(A组),再放疗34例(B组)。比较两组的并发症和生存率。结果 A组术后并发吻合口瘘1例,肺部感染3例;B组再放疗后并发食管穿孔1例,食管气管瘘2例。A组3年复发率低于B组(43.5%vs.82.4%,P<0.05)。A组1、2、3年无病生存率分别为56.5%、34.8%、26.1%,明显高于B组的41.2%、20.6%、8.8%(P<0.05)。但两组1、2、3年总生存率相仿。结论食管癌根治性放疗后复发患者可考虑手术治疗,能提高无病生存率。
Objective To compare the effects of surgery and reradiation in patients with recurrent esophageal cancer after radical radiotherapy. Methods Of the 57 patients with recurrent esophageal cancer after radical radiotherapy, 23 cases were treated by surgery (group A) and 34 cases were treated by radiotherapy (group B). Complications and survival rates were compared between the two groups. Results In group A, there were 1 case of anastomotic fistula and 3 cases of pulmonary infection. In group B, 1 case of esophageal perforation and 2 cases of esophageal tracheal fistula were observed after radiotherapy. The recurrence rate in group A at 3 years was lower than that in group B (43.5% vs 82.4%, P <0.05). The 1, 2 and 3 year disease-free survival rates in group A were 56.5%, 34.8% and 26.1%, respectively, which were significantly higher than those in group B (41.2%, 20.6% and 8.8%, P <0.05). However, the overall survival rates of the two groups at 1, 2 and 3 years were similar. Conclusion Patients with esophageal recurrence after radical radiotherapy may be considered for surgical treatment, can improve the disease-free survival rate.