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目的:探讨食管癌根治术后调强辅助放疗的近期疗效和副作用。方法:回顾分析41例术后调强辅助放疗食管癌患者的临床资料,数据用SPSS 17统计软件处理,分析1、2年的生存率、复发率、转移率的影响因素及治疗副作用。结果:全组1、2年的生存率分别是79%、51%,复发率是43%、70%,转移率是47%、72%。主要副作用为轻度(Ⅰ、Ⅱ级)毒性,消化道反应占75.7%,呼吸道反应占29.2%,白细胞计数下降占75.6%,贫血占31.7%,血小板减少占7.3%。单因素分析显示,放化疗前CT分期、术后淋巴结转移个数、放疗剂量与生存率密切相关;多因素分析显示,术中有无癌性浸润是转移率的影响因素(χ2=4.12,P=0.04)。结论:食管癌术后调强辅助放疗可提高肿瘤局部控制率,但未显示出短期生存优势。虽有较高的消化道毒性,但可耐受。术中有无癌性浸润是转移率影响因素。
Objective: To investigate the short-term curative effect and side effects of adjuvant radiotherapy after esophageal cancer radical mastectomy. Methods: The clinical data of 41 patients with esophageal cancer treated with intensity-modulated radiation assisted therapy were retrospectively analyzed. The data were processed with SPSS 17 software to analyze the factors of 1-year and 2-year survival rate, recurrence rate and metastasis rate and treatment side effects. Results: The overall survival rates of one and two years were 79% and 51% respectively, the recurrence rates were 43% and 70%, and the metastatic rates were 47% and 72% respectively. The main side effects were mild (Grade I and II) toxicities. Gastrointestinal reactions accounted for 75.7%, respiratory reactions accounted for 29.2%, leukocyte count decreased 75.6%, anemia accounted for 31.7%, and thrombocytopenia 7.3%. Univariate analysis showed that CT staging, postoperative lymph node metastasis, radiotherapy dose and survival rate were closely related. Multivariate analysis showed that the presence or absence of cancer infiltration was the influencing factor of metastasis (χ2 = 4.12, P = 0.04). Conclusions: Adjusted postoperative esophageal cancer adjuvant radiotherapy can improve the local control rate of tumor, but does not show short-term survival advantage. Although high gastrointestinal toxicity, but tolerable. Intraoperative tumor invasion or metastasis is the influencing factor.