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[目的]分析食管胸段鳞癌根治术后复发特点,探索术后预防性照射的指征和预防性放射治疗的靶区。[方法]回顾性分析2006年10月至2011年3月期间收治的111例食管胸段鳞状细胞癌根治术后复发病例的临床资料。[结果]111例胸段食管癌根治术后复发病例约70%患者T分期为T3,一半患者淋巴结转移阳性,70.2%患者病理分期为Ⅲ期。复发部位主要是双侧锁骨上(33.3%)、气管食管沟淋巴结(27.9%)、上纵隔淋巴结(19.8%),吻合口复发约10%,而瘤床复发只有2.7%(3例)。[结论]食管胸段鳞癌术后上纵隔、锁骨上是主要的失败区域,术后预防性放射治疗靶区应主要以上纵隔以及双侧锁骨上为主。
[Objective] To analyze the characteristics of recurrence of esophageal thoracic squamous cell carcinoma after radical operation and to explore the indication of postoperative prophylactic irradiation and the target area of preventive radiotherapy. [Methods] The clinical data of 111 cases of esophageal thoracic squamous cell carcinoma recurrence after radical surgery between October 2006 and March 2011 were retrospectively analyzed. [Results] T-stage of T3 was found in about 70% of 111 cases of thoracic esophageal cancer recurrence, lymph node metastasis was positive in half of the patients, and stage Ⅲ in 70.2% of the patients. The recurrent sites were mainly bilateral supraclavicular (33.3%), tracheobronchial lymph nodes (27.9%), mediastinal lymph nodes (19.8%), anastomotic recurrence of about 10%, and tumor bed recurrences of only 2.7% (3). [Conclusion] The esophageal thoracic squamous cell carcinoma of the upper mediastinum and the supraclavicular is the main failure area. The target area of postoperative preventive radiotherapy should mainly be the mediastinum above and the supraclavicular supraclavicular.