CAJ | 학술논문

目的探讨胸段食管癌根治术后预防性照射的范围对长期生存的影响.方法回顾分析2000-2007年间201例胸段食管癌根治术后行预防性照射患者资料,比较照射范围差异对生存影响,并对可能影响预后的因素行Cox模型多因素分析.Kaplan-Meier法计算OS率,Logrank检验差异.结果 5年随访率为97.0％.全纵隔、全纵隔+胃左区、全纵隔+双锁骨上区、中上纵隔+双锁骨上区、全纵隔+双锁骨上+胃左区照射的5年OS率分别为21.7％、37.1％、38.7％、34.8％、19.8％(P =0.406),多因素分析结果显示仅仅术后N分期为预后影响因素(P =0.009).预防性照射后锁骨上淋巴结转移11例、中上纵隔淋巴结转移34例、腹腔淋巴结转移10例.结论胸段食管癌根治术后预防性照射范围应包括中上纵隔和双锁骨上区.
목적 탐토흉단식관암근치술후예방성조사적범위대장기생존적영향.방법 회고분석2000-2007년간201례흉단식관암근치술후행예방성조사환자자료,비교조사범위차이대생존영향,병대가능영향예후적인소행Cox모형다인소분석.Kaplan-Meier법계산OS솔,Logrank검험차이.결과 5년수방솔위97.0％.전종격、전종격+위좌구、전종격+쌍쇄골상구、중상종격+쌍쇄골상구、전종격+쌍쇄골상+위좌구조사적5년OS솔분별위21.7％、37.1％、38.7％、34.8％、19.8％(P =0.406),다인소분석결과현시부부술후N분기위예후영향인소(P =0.009).예방성조사후쇄골상림파결전이11례、중상종격림파결전이34례、복강림파결전이10례.결론 흉단식관암근치술후예방성조사범위응포괄중상종격화쌍쇄골상구.
Objective To investigate the effect of the extent of postoperative prophylactic radiotherapy after radical surgery on the long-term survival in patients with thoracic esophageal carcinoma.Methods A retrospective analysis was performed on the clinical data of 201 patients with thoracic esophageal cancer who received postoperative prophylactic radiotherapy after radical surgery from 2000 to 2007.The effect of the extent of radiotherapy on survival was evaluated,and the possible prognostic factors were subjected to multivariate Cox regression analysis.The Kaplan-Meier method was used to calculate overall survival (OS) rates,and the log-rank test was used for survival difference analysis.Results The 5-year follow-up rate was 97.0％.The OS rates for patients who received radiotherapy to the whole mediastinum,whole mediastinum + lymph nodes along the left gastric artery,whole mediastinum + bilateral supraclavicular regions,upper and middle mediastinum + bilateral supraclavicular regions,and whole mediastinum + bilateral supraclavicular regions + lymph nodes along the left gastric artery were 21.7％,37.1％,38.7％,34.8％,and 19.8％,respectively (P =0.406).Multivariate analysis showed that postoperative N stage was the independent prognostic factor (P =0.009).After prophylactic irradiation,metastases to the supraclavicular lymph nodes,lymph nodes in the upper and middle mediastinum,and abdominal lymph nodes were observed in 11,34,and 10 patients,respectively.Conclusions The extent of postoperative prophylactic radiotherapy after radical surgery for thoracic esophageal carcinoma only includes upper and middle mediastinum and bilateral supraclavicular regions.