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目的探讨经左胸食管癌根治术后复发进展模式,以及在三维治疗条件下该术式术后放射治疗布野设计。方法 96例经病理确诊的食管癌根治术后复发进展患者,所有患者均为行经左胸食管癌根治术、R0切除。术后分期按AJCC第7版分期标准分期。回顾分析患者复发进展具体情况。结果 96例食管癌术后进展患者中,出现隆突以上进展、隆突以下进展、远处转移及复合进展患者分别占53.1%、13.5%、22.9%和10.4%,以隆突以上进展者最多。对术后给予放疗或放化疗联合治疗患者分层分析,出现隆突以上进展者仅占37.1%。而对于术后未予放疗患者,隆突以上进展者高达63.8%。结论食管癌术后进展情况以局部复发转移为主,对于术后考虑放疗患者,给予术后上纵隔联合锁骨上野预防照射,有可能带来局部控制获益,尤其对胸中上段患者可考虑给予淋巴引流区预防照射。
Objective To explore the mode of recurrence after radical surgery of left thoracic esophageal cancer, and to design the radiotherapy field after three-dimensional treatment. Methods Ninety-six patients with pathologically confirmed esophageal cancer who underwent radical resection were all followed up with R0 resection. Staging according to AJCC seventh edition staging staging. Retrospective analysis of the progress of patients with specific circumstances. Results Among the 96 patients with advanced esophageal cancer, there were more progress of the carina than that of the carina. The progress of the carina was 53.1%, 13.5%, 22.9% and 10.4% . Postoperative radiotherapy or chemoradiotherapy combined treatment of patients stratified analysis, the emergence of more than 37% of those who progress over the process of protrusion. For patients who did not receive radiotherapy, the progression of the carina was as high as 63.8%. Conclusions The postoperative progression of esophageal carcinoma is mainly local recurrence and metastasis. For postoperative patients considering radiotherapy, postoperative supral mediastinum combined with supraclavicular hernia prevention may be beneficial to local control, especially for patients with upper thoracic lymph nodes Drainage area to prevent irradiation.