局部晚期肝门部胆管癌根治术后放射治疗

目的回顾性分析及评价肝门部胆管癌根治性术后放射治疗的结果.方法 1992年3月～1997年12月76例肝门部胆管癌患者接受根治性手术,其中47例术后病理显示切缘有镜下残留(R1组),47例中28例接受术后放射治疗(S RT组),6～15MV X线外照射,靶区剂量达45～62Gy,中位剂量52Gy.术后中位随访期30个月(4～113个月).结果(n=47)总5年生存率28%,中位生存期19.6个月.S RT组(n=28)5年生存率、中位生存期显著高于S组(n=19),分别为34%、29个月和14%、10.0个月(P=0.0141).结论根治性手术结合放射治疗可明显延长切缘阳性患者的生存期;早、晚期放射反应可以耐受.

Role of postoperative radiotherapy in the management on local advanced hilar cholangiocarcinoma

To retrospective evaluate the outcome of radiotherapy (RT) for patients with locol advanced hilar cholangiocarcinoma who had undergone radical resection. Methods From March 1992 to December 1997, 76 patients with locol advanced hilar cholangiocarcinoma underwent radical resection. Of these patients, 47 had positive microscopic surgical margins (R). 28 received 45-62Gy of external beam radiation therapy (S + RT). The median follow-up period for all the patients was 30 months (range 4-113) . Results Of these 47 patients, the overall 5-years survival rate and the median survival periods was 28% and 19.6 months. The 5-years survival rate and the median survival periods for patients who had received radiotherapy after radical surgery was 34% and 29 months. It was longer than 14% and 10.0 months for patients who had undergone radical resection alone ( P=0.0141) . Conclusion Postoperative radiotherapy may obviously prolong the survival period of the patients with positive microscopic surgical margins who had undergone radical resection.