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[目的]探讨局部晚期食管癌术前放化疗联合胸腹腔镜下食管癌根治术术前放疗的最佳靶区范围及方案的安全性、有效性。[方法]前瞻性收集39例局部晚期食管癌患者,通过靶区范围递增试验(分累及野组、胸廓入口组、扩大野组)确立术前放疗最佳放疗靶区并评价临床疗效及不良反应。[结果]通过靶区递增试验确定最大范围靶区为胸廓入口组。胸廓入口组的放化疗相关3度以上不良反应有骨髓抑制(81.81%)、消化道反应(3.03%)、放射性食管炎(3.03%)、手术相关并发症以术后肺部感染(23.33%)为主。R0切除率为97.44%,p CR率为51.28%,1年生存率为86.67%,2年生存率为61.34%。[结论]局部晚期食管癌术前放疗靶区胸廓入口最佳且安全有效。
[Objective] To explore the best target range of preoperative radiotherapy and radiotherapy combined with laparoscopic laparoscopic esophagectomy for esophageal cancer and its safety and efficacy. [Methods] A total of 39 patients with locally advanced esophageal cancer were prospectively enrolled. The best target of radiotherapy for preoperative radiotherapy was established and the clinical efficacy and adverse reactions were evaluated by increasing the range of target area (divided into wild group, thoracic entrance group and extended group) . [Result] The largest target area was defined as the thoracic entrance group by increasing the target area. Radiotherapy (3.03%), gastroesophageal reflux disease (3.03%), and postoperative pulmonary infection (23.33%) were associated with more than 3 degrees of radiotherapy and chemotherapy related adverse events in the thoracic portal group. Mainly. R0 resection rate was 97.44%, p CR rate was 51.28%, 1-year survival rate was 86.67%, 2-year survival rate was 61.34%. [Conclusion] The best thoracic portal for preoperative radiotherapy of locally advanced esophageal cancer is safe and effective.