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目的探讨适形放疗食管癌腹膜后淋巴结转移的疗效。方法 33例食管癌伴腹膜后淋巴结转移患者,给予适形放疗,180～200cGy/f,80%～90%以上的等剂量线包括靶区,腹膜后总剂量36～60Gy。结果完全缓解(CR)率30.3%(10/33)、部分缓解(PR)率48.5%(16/33),无变化(NC)+进展(PD)率22.2%(7/33),总有效率(CR+PR)78.8%(26/33)。1,2,3年生存率分别为57.6%(19/33)、21.2%(7/33)和9.1%(3/33)。中位生存期18个月。单因素分析显示,放疗体积、症状缓解、放疗剂量、转移淋巴结大小、是否同时发病、是否伴有癌栓等对生存期有影响;多因素分析显示,放疗体积、症状缓解与生存情况有关,而放疗剂量、食管病变位置、转移淋巴结大小、是否同时发病、是否伴有癌栓等与生存情况无关。结论三维适形放疗治疗食管癌伴腹膜后淋巴结转移安全有效;放疗体积越小,效果越好。
Objective To investigate the curative effect of conformal radiotherapy on retroperitoneal lymph node metastasis of esophageal cancer. Methods 33 cases of esophageal cancer with retroperitoneal lymph node metastasis were given conformal radiotherapy, 180 ~ 200cGy / f, more than 80% ~ 90% of the dose line including the target area, the total retroperitoneal dose of 36 ~ 60Gy. Results The complete remission (CR) rate was 30.3% (10/33), partial remission (PR) rate was 48.5% (16/33), no change (NC) + progress rate was 22.2% (7/33) Efficiency (CR + PR) 78.8% (26/33). The 1, 2, 3 year survival rates were 57.6% (19/33), 21.2% (7/33) and 9.1% (3/33), respectively. The median survival was 18 months. Univariate analysis showed that radiotherapy volume, symptom relief, radiotherapy dose, size of metastatic lymph node, simultaneous onset of disease, whether accompanied with thrombus or not had an impact on survival; multivariate analysis showed that radiotherapy volume and symptom relief were related to survival, Radiation dose, esophageal lesion location, size of lymph node metastasis, whether at the same time, whether associated with cancer thrombus and other survival has nothing to do. Conclusion Three-dimensional conformal radiotherapy for esophageal cancer with retroperitoneal lymph node metastasis is safe and effective; the smaller the volume of radiotherapy, the better the effect.