【摘要】 目的　探讨食管癌治疗后纵隔淋巴结转移三维适形放疗的价值。方法　 44例食管癌患者治疗后 2～ 60个月发生纵隔淋巴结转移 ,手术后 18例 ,手术加放疗后 6例 ,放疗后 2 0例。单纯适形放疗 3 0例 ,加用常规放射治疗 14例。结果　急性放射性气管炎发生率Ⅰ～Ⅱ级 2 7 3 %( 12 /4 4)、Ⅲ～Ⅳ级 2 0 5 %( 9/4 4) ;急性放射性食管炎发生率Ⅰ～Ⅱ级 3 1 8%( 14 /4 4)、Ⅲ～Ⅳ级 11 4%( 5 /4 4) ;近期疗效为完全缓解 (CR) 3 1 8%( 14 /4 4) ,部分缓解 (PR) 5 0 %( 2 2 /4 4)。 1、2年生存率分别为 72 7%( 3 2 /4 4)、40 9%( 18/4 4)。结论　三维适形放射治疗食管癌治疗后纵隔淋巴结转移有较好的疗效 ,患者均能耐受更多还原

【Abstract】 Objective To study the value of 3_dimensional conformal radiation therapy of lymph node metastasis in mediastinum after treatment for esophageal carcinoma Methods Forty_four patients with esophageal carcinoma who developed lymph node metastasis in mediastinum 2～60 months after the treatment,18 cases after surgery,6 after surgery and radiotherapy and 20 after radiotherapy 30 patients were treated by 3_DCRT alone and 14 patients by 3_DCRT plus conventional radiotherapy.Results Grade Ⅰ～Ⅱ acute radiation bronchitis occurred in 27 3% (12/44) and grade Ⅲ～Ⅳ in 20 5% (9/44) patients; Grade Ⅰ～Ⅱacute radiation esophagitis occurred in 31 8% (14/44) and grade Ⅲ～Ⅳ in 11 4% (5/44) patients; The immediate response rate was complete response (CR), 31 8% (14/44) ,Partial response (PR) was 50% (22/44) The 1-and 2-year actuarial survivals were 72 7% (32/44) ?40 9% (18/44) Conclusion For lymph node metastasis in mediastinum after the treatment for esophageal carcinoma,the better outcome of 3_DCRT makes It is tolerable更多还原