中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2014年
34期
7-8
,共2页
张正荣%袁昕%殷旭东%汪竹%童建东
張正榮%袁昕%慇旭東%汪竹%童建東
장정영%원흔%은욱동%왕죽%동건동
食管癌%左胸食管癌根治术%放疗%复发
食管癌%左胸食管癌根治術%放療%複髮
식관암%좌흉식관암근치술%방료%복발
Esophageal cancer%Radical surgery for left thoracic esophageal carcinoma%Radiotherapy%Relapse
目的：探讨经左胸食管癌根治术后复发进展模式，以及在三维治疗条件下该术式术后放射治疗布野设计。方法96例经病理确诊的食管癌根治术后复发进展患者，所有患者均为行经左胸食管癌根治术、R0切除。术后分期按AJCC第7版分期标准分期。回顾分析患者复发进展具体情况。结果96例食管癌术后进展患者中，出现隆突以上进展、隆突以下进展、远处转移及复合进展患者分别占53.1%、13.5%、22.9%和10.4%，以隆突以上进展者最多。对术后给予放疗或放化疗联合治疗患者分层分析，出现隆突以上进展者仅占37.1%。而对于术后未予放疗患者，隆突以上进展者高达63.8%。结论食管癌术后进展情况以局部复发转移为主，对于术后考虑放疗患者，给予术后上纵隔联合锁骨上野预防照射，有可能带来局部控制获益，尤其对胸中上段患者可考虑给予淋巴引流区预防照射。
目的：探討經左胸食管癌根治術後複髮進展模式，以及在三維治療條件下該術式術後放射治療佈野設計。方法96例經病理確診的食管癌根治術後複髮進展患者，所有患者均為行經左胸食管癌根治術、R0切除。術後分期按AJCC第7版分期標準分期。迴顧分析患者複髮進展具體情況。結果96例食管癌術後進展患者中，齣現隆突以上進展、隆突以下進展、遠處轉移及複閤進展患者分彆佔53.1%、13.5%、22.9%和10.4%，以隆突以上進展者最多。對術後給予放療或放化療聯閤治療患者分層分析，齣現隆突以上進展者僅佔37.1%。而對于術後未予放療患者，隆突以上進展者高達63.8%。結論食管癌術後進展情況以跼部複髮轉移為主，對于術後攷慮放療患者，給予術後上縱隔聯閤鎖骨上野預防照射，有可能帶來跼部控製穫益，尤其對胸中上段患者可攷慮給予淋巴引流區預防照射。
목적：탐토경좌흉식관암근치술후복발진전모식，이급재삼유치료조건하해술식술후방사치료포야설계。방법96례경병리학진적식관암근치술후복발진전환자，소유환자균위행경좌흉식관암근치술、R0절제。술후분기안AJCC제7판분기표준분기。회고분석환자복발진전구체정황。결과96례식관암술후진전환자중，출현륭돌이상진전、륭돌이하진전、원처전이급복합진전환자분별점53.1%、13.5%、22.9%화10.4%，이륭돌이상진전자최다。대술후급여방료혹방화료연합치료환자분층분석，출현륭돌이상진전자부점37.1%。이대우술후미여방료환자，륭돌이상진전자고체63.8%。결론식관암술후진전정황이국부복발전이위주，대우술후고필방료환자，급여술후상종격연합쇄골상야예방조사，유가능대래국부공제획익，우기대흉중상단환자가고필급여림파인류구예방조사。
Objective To investigate the relapse pattern after radical surgery for left thoracic esophageal carcinoma, and the radiotherapy field design with three dimensional treatment after the radical surgery. Methods A total of 96 diagnosed esophageal cancer patients with postoperative relapse were enrolled, and they all underwent radical surgery for left thoracic esophageal carcinoma and R0 resection. AJCC standard version 7 was used for postoperative stage. The relapse progress was retrospectively analyzed. Results Among the 96 patients, the cases with progress above the carina, progress under the carina, distant metastasis, and complex progress respectively accounted for 53.1%, 13.5%, 22.9% and 10.4%, and the number of progress above the carina was the most. Stratified analysis was made on cases received radiotherapy or chemoradiotherapy, and there were 37.1%of the patients with progress above the carina. While there were 63.8%of the patients, who received no chemoradiotherapy, with progress above the carina. Conclusion Postoperative progression of esophageal cancer mainly occurs through local relapse and metastasis. Postoperative irradiation of mediastinal and joint supra clavicular area may bring benefit for patients, especially for those received chemoradiotherapy. The preventive irradiation of lymphatic drainage area can be considered for patients with cancer in thoracic upper middle section.
