食管癌根治术后局部复发转移的放射治疗疗效分析

目的探讨食管癌根治术后局部复发转移的放射治疗（放疗）的效果。方法对161例食管癌根治术后4—42个月发生局部转移患者，随机分为两组。一组80例行单纯放疗（单放组），另一组81例行放疗同步应用DFL（顺铂＋5-氟脲嘧啶＋亚叶酸钙）方案化疗（综合组）。放疗采用^60Coγ射线常规照射Dr50—70Gy，化疗与放疗同步，每3周为1个化疗周期，共化疗2—3个周期，放疗剂量同单放组，两组均随访满3年。结果单放组和综合组的中位生存期分别为9个月和16个月；局部控制率分别为28．2％和55．8％，两组比较差异有统计学意义（x^2=11．0，P〈0．001）：两组1、2、3年生存率分别为40．0％、16．3％、5．0％和60．5％、37．0％、24．7％，两组比较差异有统计学意义（P〈0．05或〈0．01）。结论放疗是食管癌根治术后局部复发和淋巴结转移的有效治疗方法，放疗结合化疗对患者有益处。

Radiotherapy in local recurrence of esophageal carcinoma after surgery

Objective To study the effect of radiotherapy in local recurrence of esophageal cancinoma after surgery. Methods One hundred and sixty-one patients with esophageal carcinoma who developed mediastinal metastasis after 4 to 42 months of the radical surgery, these cases were randomized into two groups. One group was radiotherapy alone group (80 patients), another group was radio-chemotherapy group with DFL (DDP+5-FU+CF) scheme (81 patients). Cobalt was used for all patients, with 3 fields to deliver 50-70 Gy. Chemotherapy was given every 3 weeks for 2-3 cycles when radiotherapy in radio-chemotherapy group . Both groups were followed up for 3 years. Results The median survival rate of radiotherapy alone group was 9 months, radio-chemotherapy group was 16 months. The local control rates were 28.2% in radiotherapy alone group and 55.8% in radio-chemotherapy group. 1, 2 and 3 year survival rates were 40.0%, 16.3%, 5.0% in radiotherapy alone group and 60.5%, 37.0%, 24.7% in radio-chemotherapy group, respectively. The survival rates in radio-chemotherapy group were much better than those in radiotherapy alone group (P <0.05 or<0.01). Conclusion For patients with local recurrence after surgery of esophageal carcinoma, radiotherapy is an effective method and combined chemotherapy may prolong survival.