摘要
目的回顾分析食管癌术后食管气管沟淋巴结转移与放疗等因素的关系。方法对经术后CT及临床检查无食管气管沟淋巴结转移、就诊资料完整的食管癌患者101例,就其随访资料中食管气管沟淋巴结情况进行统计分析。101例中未予锁骨上放疗者30例(A组);行锁骨上放疗共71例,剂量<45 Gy 52例(B组),≥45 Gy 19例(C组)。照射采用60Coγ线或6 MV X线,下界常规为锁骨头下缘,按5 cm深计算肿瘤量。结果食管气管沟淋巴结转移率A组20.0%(6/30),B组9.6%(5/52),C组0.0%(0/19)。多因素分析显示食管癌术后锁骨上野的放疗是影响食管气管沟淋巴结转移的惟一因素(P=0.037),而与性别、病理分期、术前病变部位无关(P>0.10)。单因素分析放疗剂量与食管气管沟淋巴结转移结果显示,C组优于A组(P=0.039);A组与B组及B组与C组间均无差异,但A、B、C组有降低食管气管沟淋巴结转移的趋势性。结论食管癌术后锁骨上野放疗的剂量应以食管气管沟深度(常规5 cm)计算,且预防剂量至少要45 Gy。
Objective To evaluate the prognostic factors of tracheoesophageal groove lymph node （TEGLN） metastasis in postoperative esophageal carcinoma. Methods From January 1996 to December 1997, 101 postoperative cervical and thoracic esophageal carcinoma patients proved absence from tracheoesophageal groove lymph node （TEGLN） metastasis hefore and after operation by physical examination and computer tomography examination were entered into this study, The patients were divided into three groups according to the treatment of supraclavicnlar region： no prophylactic radiotherapy （group A-, 30 patients） ; prophylactic radiotherapy with local dose 〈 45 Gy （Group B-.71 patients）; and prophylactic radiotherapy with local dose 1≥45 Gy （Group C-,19 patients）, Radiotherapy was delivered by cobalt- 60 or 6 MV X-ray with the prescribed dose normalized to the point of tracheoesophageal groove, i. e, 5 cm in depth, The tracheoesophageal groove lymph node metastasis after treatment was observed. Results The incidence of tracheoesophageal groove lymph node metastasis was 20% （6/30）, 9.6% （5/71） and 0% （0/19） in groups A , B and C. Univariate analysis showed that there was significant difference of TEGLN metastasis hetween groups A and C only （ P = 0. 039）, but higher dose to supraclavicular region tended to lower the incidence of TEGLN metastasis. Multivariate analysis showed that only prophylactic radiotherapy to the supraclavicnlar region was independent prognostic factor for TEGLN metastasis （ P = 0. 037 ）. Gender, primary tumor site and pathological stage had no significant impact on TEGLN metastasis. Condusions Postoperative prophylactic supraclavicular region in-adiation can lower the incidence of tracheoesophageal groove lymph node metastasis in esophageal carcinoma. Radiotherapy dose should not he less than 45 Gy and should he routinely normalized to a point 5 cm deep in the traeheoesophageal groove.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2005年第5期401-403,共3页
Chinese Journal of Radiation Oncology
