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临床T1~2N0~1M0食管癌放疗长期疗效、治疗失败原因和选择性淋巴结照射结果分析

沈文斌, 高红梅, 祝淑钗, 李幼梅, 李 娟, 苏景伟, 刘志坤, 李曙光

沈文斌, 高红梅, 祝淑钗, 李幼梅, 李 娟, 苏景伟, 刘志坤, 李曙光. 临床T1~2N0~1M0食管癌放疗长期疗效、治疗失败原因和选择性淋巴结照射结果分析[J]. 肿瘤防治研究, 2014, 41(06): 657-662. DOI: 10.3971/j.issn.1000-8578.2014.06.033
引用本文: 沈文斌, 高红梅, 祝淑钗, 李幼梅, 李 娟, 苏景伟, 刘志坤, 李曙光. 临床T1~2N0~1M0食管癌放疗长期疗效、治疗失败原因和选择性淋巴结照射结果分析[J]. 肿瘤防治研究, 2014, 41(06): 657-662. DOI: 10.3971/j.issn.1000-8578.2014.06.033
SHEN Wenbin, GAO Hongmei, ZHU Shuchai, LI Youmei, LI Juan, SU Jinwei, LIU Zhikun, LI Shuguang. Long-term Efficacy of Radiotherapy, Cause of Failure and Results of Elective Nodal Irradiation for Clinical T1-2N0-1M0 Stage Esophageal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2014, 41(06): 657-662. DOI: 10.3971/j.issn.1000-8578.2014.06.033
Citation: SHEN Wenbin, GAO Hongmei, ZHU Shuchai, LI Youmei, LI Juan, SU Jinwei, LIU Zhikun, LI Shuguang. Long-term Efficacy of Radiotherapy, Cause of Failure and Results of Elective Nodal Irradiation for Clinical T1-2N0-1M0 Stage Esophageal Carcinoma[J]. Cancer Research on Prevention and Treatment, 2014, 41(06): 657-662. DOI: 10.3971/j.issn.1000-8578.2014.06.033

临床T1~2N0~1M0食管癌放疗长期疗效、治疗失败原因和选择性淋巴结照射结果分析

详细信息
    作者简介:

    沈文斌(1979-),男,硕士,副主任医师,主要从事肿瘤放射治疗研究

    通讯作者:

    祝淑钗,E-mail: sczhu@heinfo.net

  • 中图分类号: R735.1

Long-term Efficacy of Radiotherapy, Cause of Failure and Results of Elective Nodal Irradiation for Clinical T1-2N0-1M0 Stage Esophageal Carcinoma

  • 摘要: 目的 明确和评价临床可手术切除食管癌放射治疗的疗效,分析其治疗失败的原因,同时对选择性淋巴结照射的可行性进行分析。方法 对可能影响入组食管癌患者预后的生存因素进行分析,并对其死亡原因进行详细分析。同时对进行了选择性淋巴结照射的21例患者的生存相关情况与其他102例患者进行了比较研究。疾病治疗失败原因分为复发、远处转移和淋巴结转移。结果 全组患者1、3、5年总生存率及局部控制率分别为87.8%、47.2%、36.5%和89.7%、67.7%、49.0%。多因素分析显示病变X线长度、临床N分期及近期疗效是其独立的预后因素。选择性淋巴结照射并未给患者生存及局控率上带来益处,但对纵膈淋巴结转移和(或)远处转移患者有益(χ2=5.778,P=0.016)。结论 三维适形放射治疗可作为早期食管癌有效的治疗方式之一;选择性淋巴结照射可能会降低淋巴结转移率,但需要后续进一步研究证实,是否能提高患者的生存率也有待进一步研究。

     

    Abstract: Objective To evaluate the curative effect of radiation therapy, failure causes and the feasibility of elective nodal irradiation on early esophageal carcinoma. Methods We analyzed the prognostic factors and failure cause for 123 patients with squamous cell carcinoma and clinical T1-2N0-1M0 stage esophageal carcinoma. And we analyzed those 21 patients who received elective nodal irradiation. The pattern of the failure after treatment included recurrence, distant metastases and lymph nodal metastases. Results The 1-, 3-, and 5-year overall survival rates were 87.8%, 47.2% and 36.5%, respectively. The 1-, 3-, and 5-year local control rates were 89.7%, 67.7% and 49.0%. Cox multivariate model showed that the length of tumor in X-rays, clinical N stage and the response to curative effect were independent prognostic factors. Elective nodal irradiation were not benefi cial to over survival rates or local control rates, but benefi cial to local nodal and distant failure(χ2=5.778,P=0.016). Conclusion Three-dimensional conformal radiotherapy could be one of the best radiation treatment regimens for early esophageal carcinoma. Elective nodal irradiation may be effective for lowering the risk of regional nodal failure while its benefi t to overall survival is still needed further evaluation.

     

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出版历程
  • 收稿日期:  2013-04-10
  • 修回日期:  2013-09-04
  • 刊出日期:  2014-06-24

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