沈文斌, 高红梅, 祝淑钗, 李幼梅, 李娟, 苏景伟, 刘志坤, 李曙光. 临床早期食管癌选择性淋巴结照射与累及野照射的初步比较[J]. 中国肿瘤临床, 2013, 40(17): 1047-1050. DOI: 10.3969/j.issn.1000-8179.20130161
引用本文: 沈文斌, 高红梅, 祝淑钗, 李幼梅, 李娟, 苏景伟, 刘志坤, 李曙光. 临床早期食管癌选择性淋巴结照射与累及野照射的初步比较[J]. 中国肿瘤临床, 2013, 40(17): 1047-1050. DOI: 10.3969/j.issn.1000-8179.20130161
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Wenbin SHEN, Hongmei GAO, Shuchai ZHU, Youmei LI, Juan LI, Jinwei SU, Zhikun LIU, Xuguang LI. Preliminary comparative study between elective nodal irradiation and involved field radiation therapy for clinical early-stage esophageal carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(17): 1047-1050. DOI: 10.3969/j.issn.1000-8179.20130161
Citation: Wenbin SHEN, Hongmei GAO, Shuchai ZHU, Youmei LI, Juan LI, Jinwei SU, Zhikun LIU, Xuguang LI. Preliminary comparative study between elective nodal irradiation and involved field radiation therapy for clinical early-stage esophageal carcinoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(17): 1047-1050. DOI: 10.3969/j.issn.1000-8179.20130161
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临床早期食管癌选择性淋巴结照射与累及野照射的初步比较

Preliminary comparative study between elective nodal irradiation and involved field radiation therapy for clinical early-stage esophageal carcinoma

    摘要
  • 摘要:
      目的  分析食管癌患者行选择性淋巴结照射（ENI）的可行性，进一步明确和评价临床早期食管癌患者放疗疗效，并分析其治疗失败原因。
      方法  对符合入组条件的123例临床分期为T1~2N0~1M0食管癌患者进行分析。将患者依据放疗方式不同分为两组，其中ENI组21例，累及野照射（IFI）组102例，并对两组患者进行比较分析。
      结果  全组123例患者1、3、5年总生存率及局部控制率分别为87.8%（108/123）、47.2%（58/123）、36.6%（45/123）及89.4%（110/123）、67.5%（83/123）、48.8%（60/123）。ENI组患者1、3、5年总生存率分别为90.5%（19/21）、47.6%（10/21）、42.9%（9/21），与IFI组的86.3%（88/102）、49.0%（50/102）、35.2%（36/102）比较，差异无统计学意义（χ2=0.290，P=0.588 8）。ENI组与IFI组患者比较发生纵隔和（或）远处转移的患者有显著性差异（χ2= 5.778，P=0.016）。
      结论  三维适形放射治疗可作为临床早期食管癌患者有效的治疗方式之一，ENI可能会降低患者的淋巴结转移率，能否提高患者的长期生存率需进一步研究。

     

    Abstract:
      Objective  This study was performed to analyze the feasibility of elective nodal irradiation (ENI) for early-stage esophageal carcinoma (EEC), evaluate the curative effect of radiation therapy for EEC, and determine the causes of treatment failure.
      Methods  Data were collected from 123 patients with esophageal squamous cell carcinoma of clinical T1-2 N0-1 M0 stage. Patients were divided into two groups based on different types of radiation therapy. Among the 123 patients, 102 underwent involved field irradiation (IFI), whereas 21 received ENI. A comparative analysis of patients in the two groups was conducted.
      Results  In 123 patients, the one-, three-, and five-year overall survival rates were 87.8%, 47.2%, and 36.6%, respectively. By contrast, the one-, three-, and five-year local control rates were 89.4%, 67.5%, and 48.8%, respectively. After comparing the one-, three-, and five-year survival rates in the ENI patients (i.e., 90.5%, 47.6%, and 42.9%, respectively) with those in the IFI patients (i.e., 86.3%, 49.0%, and 35.2%, respectively), no significant difference was found (χ2=0.290, P=0.588 8). The results indicate that ENI possibly decreased nodal metastases (χ2=5.778, P=0.016).
      Conclusion  Three-dimensional conformal radiotherapy is one of the best therapeutic regimens of radiation for EEC. ENI is possibly effective for preventing regional nodal metastasis.Whether ENI leads to an improved overall survival needs further investigation.

     

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