[目的]对中国《非手术治疗食管癌临床分期标准(草案)》进行验证,为该草案进一步修订提供依据。[方法]收集2005~2006年行根治性三维适形放射治疗的食管癌患者236例,颈段25例,胸上段76例,胸中段118例,胸下段17例。放疗中位剂量64Gy(50~74Gy),其中有76例(32.2%)接受了以铂类为主的同期化疗。根据分期草案的标准进行T、N及临床分期,比较不同分期与总生存率的关系。[结果]73例生存患者的中位随访时间为50(10~72)个月,5年总生存率为26.2%。236例患者中,T1、T2、T3和T4的5年生存率分别为100%、35.2%、24.3%、19.8%(P=0.006),生存曲线均无交叉。N0、N1和N2的5年生存率分别为50.7%、16.5%、23.7%(P=0.087),其中N2组与N1组生存曲线存在交叉。Ⅰ、Ⅱ和Ⅲ期5年生存率分别为50.7%、0和23.7%(P=0.033),Ⅱ、Ⅲ期生存曲线有交叉。有30例胸段食管癌存在胸廓入口以上食管旁小淋巴结转移(5mm<最长径<10mm),如将这部分患者N分期定义为N1,则N0、N1和N2的5年总生存率分别为34.3%、26.6%和19.4%(P=0.029),各期生存曲线均能很好分开;由此定义的临床分期Ⅰ、Ⅱ和Ⅲ期5年生存率分别为50.7%、31.2%和20.7%(P=0.009),各期生存曲线均能很好分开。[结论]非手术治疗食管癌临床分期草案T分期可以较好地反映预后,N分期标准存在不足。建议将有胸段食管癌胸廓入口以上单纯食管旁小淋巴结转移(最长径<10mm)者定义为N1。 [Objective] To verify the “non-surgical treatment of esophageal cancer clinical staging standards (draft)” to provide a basis for further revision of the draft. [Methods] A total of 236 patients with esophageal cancer who underwent radical three-dimensional conformal radiotherapy from 2005 to 2006 were selected, including 25 cases of cervical segment, 76 cases of upper thoracic segment, 118 cases of mid-chest segment and 17 cases of lower thoracic segment. The median dose of radiotherapy was 64 Gy (50-74 Gy), of which 76 (32.2%) received concurrent platinum-based chemotherapy. T, N and clinical staging were performed according to the standard of staging, and the relationship between different staging and overall survival rate was compared. [Results] The median follow-up time of 73 survivors was 50 (10 ~ 72) months, and the 5-year overall survival rate was 26.2%. Among the 236 patients, the 5-year survival rates of T1, T2, T3 and T4 were 100%, 35.2%, 24.3% and 19.8%, respectively (P = 0.006), with no survival curves. The 5-year survival rates of N0, N1 and N2 were 50.7%, 16.5% and 23.7%, respectively (P = 0.087). The survival curves of N2 and N1 were cross-over. The 5-year survival rates of Ⅰ, Ⅱ and Ⅲ were 50.7%, 0 and 23.7% respectively (P = 0.033). The survival curves of stage Ⅱ and Ⅲ were cross-over. Thoracic esophageal cancer was found in 30 cases of thoracic esophageal cancer with metastasis to the small esophageal lymph nodes (5mm