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目的:探讨三维适形放疗联合化疗治疗食管癌上纵隔淋巴结转移的近期疗效。方法:回顾性分析15例食管癌上纵隔淋巴结转移患者。转移灶直径<3cm4例,3～5cm8例,>5cm3例,15例中右上纵隔13例,左上纵隔2例。三维适形放疗采用常规分割,1.8～2Gy/次,5次/周,总剂量50～64Gy(既往做过放疗的给予50Gy),5～7周完成。全身化疗采用顺铂(DDP)30mg/m2,d1～d3;亚叶酸钙(LV)500mg/m2,d1～d5;5-氟尿嘧啶(5-FU)500mg/m2,d1～d5,均静脉滴入,21d为1个周期,放疗前化疗1个周期,共4～6个周期。结果:治疗后1个月复查,病灶达CR者9例,病灶达PR者4例,无进展病例。6个月、1年生存率分别为100%、86.7%。结论:食管癌上纵隔淋巴结转移进行三维适形放射治疗联合PF方案化疗,此方案患者可耐受,方法可行。
Objective: To investigate the short-term effect of three-dimensional conformal radiotherapy combined with chemotherapy in the treatment of mediastinal lymph node metastasis of esophageal cancer. Methods: A retrospective analysis of 15 cases of esophageal cancer patients with mediastinal lymph node metastases. The diameter of metastatic lesions was 3 cm in 4 cases, 3 to 5 cm in 8 cases, and> 5 cm in 3 cases. Among 15 cases, 13 were upper right mediastinum and 2 left superior mediastinum. Three-dimensional conformal radiotherapy using conventional segmentation, 1.8 ~ 2Gy / time, 5 times / week, the total dose of 50 ~ 64Gy (previously done radiotherapy 50Gy), 5 to 7 weeks to complete. Systemic chemotherapy with cisplatin (DDP) 30mg / m2, d1 ~ d3; leucovorin (LV) 500mg / m2, d1 ~ d5; 5-FU 500mg / m2, d1 ~ d5, , 21d for a period of chemotherapy before radiotherapy 1 cycle, a total of 4 to 6 cycles. Results: One month after treatment, there were 9 cases of CR in the lesion, 4 cases of PR in the lesion, and no progress. The 6-month and 1-year survival rates were 100% and 86.7% respectively. Conclusion: Three-dimensional conformal radiotherapy combined with PF regimen chemotherapy for esophageal carcinoma metastasis to the mediastinum lymph nodes is tolerable and the method is feasible.