【摘要】 目的:对胸段食管鳞癌三野根治术患者的不同淋巴结转移个数与术后放疗的疗效进行分析,评价胸段食管鳞癌术后放疗价值。方法:收集1993-01-01-2007-03-30福建省肿瘤医院收治的胸段食管鳞癌三野淋巴结清除根治术患者1 715例,其中单纯手术1277例,术后放疗438例。术后3~4周开始放疗,中位总剂量50 Gy,2 Gy/次,5次/周,5周完成。结果:全组5年生存率为49.4%,其中淋巴结转移个数为0、1~2、3~5和>5枚的5年生存率分别为71.7%、45.0%、25.8%和11.8%,χ2=371.460,P=0.000。术后放疗与单纯手术比较可以提高淋巴结转移≥3枚患者的生存率,差异有统计学意义,χ2=10.388,P=0.001;淋巴结转移<3枚患者的生存率差异无统计学意义,χ2=1.970,P=0.160。结论:术后放疗能提高淋巴结转移≥3枚的生存率。更多还原

【Abstract】 OBJECTIVE:To analyze the treatment results and evaluate the postoperative radiotherapy of three-field lymphadenectomy in esophageal squamous cell carcinoma(ESCC) with different numbers of positive lymph nodes.METHODS:From January 01 1993 to March 30 2007,1 715 patients of thoracic ESCC were treated with enrolled in this study after three-field lymphadenectomy in ESCC with three-field lymphadenectomy.Among them,1 277 patients received surgery(three-field lymphadenectomy) alone,438 patients received surgery followed by postoperative radiotherapy.Radiotherapy started within 3 to 4 weeks after surgery.The median total dose was 50 Gy(2 Gy/f,25 fractions,completed in 5 weeks).RESULTS:The total 5-year survival rate was 49.4%.According to the numbers of positive lymph nodes(0,1-2,3-5 and over 5),the 5-year survival rates were 71.7%,45.0%,25.8% and 11.8% respectively(χ2=371.460,P=0.000).Compared with surgery alone,postoperative radiotherapy could improve the survival rates of the patients with ≥3 positive lymph nodes(χ2=10.388,P=0.001),but there were no difference for the patients with <3 positive lymph nodes(χ2=1.970,P=0.160).CONCLUSION:Postoperative radiotherapy can improve the survival rates of the patients of ESCC with ≥3 positive lymph nodes following three-field lymphadenectomy.更多还原