Clinical Analysis of Prophylactic Postoperative Radiotherapy or Sequence Radiotherapy andChemotherapy in Esophageal Carcinoma

Objective 　To analysis clinical value of prophylactic radiotherapy or sequence radiotherapy and chemotherapy in esophageal carcinoma af ter surgery. Methods 　163 esophageal carcinoma cases who had undergone radical resection followed prophylactic radiotherapy. Among them, 125 cases t reated with radiotherapy alone ( RT group ), 38 cases t reated with sequence chemotherapy af ter radiotherapy ( RCT group) . Radiation t reatment was started less than 2 months af ter operation. The fields encompassed the whole mediastinum in most patient s, 44 cases inclosed bilateral supraclavicular areas. A mid-plane dose of 45～60 Gy in 23～30 f ractions over 4. 5～6 weeks was delivered. Results 　The overall 1, 3, 5-year survival rate and median survival time was 84. 05 %, 45. 75 %, 35. 89 % and 32 months respectively. Stage T, N, TNM, total doses of radiotherapy and chemotherapy effected prognosis of esophageal carcinoma treated with postoperative radiotherapy, P < 0. 05 ; but only stage TNM and chemotherapy are independent prognostic factor. 1, 3, 5 year survival rate for stage III patient s were 73. 91 %, 31. 97 %, 26. 23 % and was lower than 91. 49 %, 55. 81 %, 43. 24 % in stage I + II(χ2 = 12. 22, P = 0. 001) . The 1, 3, 5 year survival rate was 84. 00 %, 50. 6 % and 39. 18 % for RT group and 84. 21 %, 29. 91 % and 24. 93 % for group RCT(χ2 = 5. 02, P = 0. 025) . Conclusion 　TNM stage and chemotherapy are independent prognostic factor in patient s of esophageal carcinoma accepted postoperative radiotherapy, the t rue reason why chemotherapy decreased survival in these patient s need further research.