摘要
目的分析单纯Barrett’s食管腺癌根治性手术切除后加用放、化疗的临床疗效,探讨影响Barrett’s食管腺癌预后的因素。方法回顾性分析108例Barrett’s食管腺癌患者的临床资料及随访结果。行根治性手术切除者92例,其中术后单纯放疗者76例,术后放疗后加用化疗者16例;姑息性手术治疗者16例,其中有4例患者于术中死亡,另12例患者在术后均采用放疗+化疗。放疗采用60钴或6MV-X线,体外常规分割照射,靶区放射治疗总剂量为55～70 Gy;化疗采用FAM或CMF方案4～6个疗程。结果采用Kaplan-Meier法计算其生存率,本组患者1、3、5年生存率分别为81.5%、51.9%和22.2%,其中根治性手术切除后单纯放疗者5年生存率为15.8%,术后放疗加化疗者为75.0%;有肿瘤外侵者5年生存率为9.1%,无肿瘤外侵者为33.3%;有淋巴结转移者5年生存率为14.3%,无淋巴结转移者为33.3%;姑息性手术治疗术后加放、化疗后5年生存率为0。Log rank检验结果显示,差异均有统计学意义(P<0.05)。结论单纯Barrett’s食管腺癌根治性手术切除后,及时加用放、化疗治疗,有助于疗效的提高。影响预后的主要因素为临床分期、肿瘤外侵、淋巴结转移和根治性手术切除后放、化疗措施的应用。
Objective To investigate the prognostic factors and to analyze the efficacy of chemotherapy and/or radiotherapy for Barrett＇s esophageal ad Methods The clinical data of 108 patients with ad after radical surgical resection Barrett＇s esophagus picking out from 783 esophageal adenocarcinoma patients surgically treated between June 1978 to June 2001 in the Shandong Provincial Hospital and Shandong Qianfoshan Hospital were analyzed retrospectively. ^60Co γ-irradiation or 6MVX-ray with conventional fraction were used for radiotherapy with a total volume dosage of 55-70 Gy. The chemotherapy was either FAM（ iv infusion of 5-Fu 500 mg, d1-d5 ; ADM 50 mg d1 ; MMC 12 mg, d1 ） or CMF regimen（ iv infusion of CTX 800 mg d1 , ds ; MTX 30 mg d1 ; 5-Fu 500 mg, d1 -d5 ） for 4-6 cycles. The Kaplan-Meier amalysis was used to estimate the survival rate. Log rank test was used for comparison of the survival difference among different groups. Results In this series, 76 of 92 patients who underwent radical surgical resection received postoperative radiotherapy alone, and 16 received radiotherapy plus chemotherapy. Twelve of the other 16 patients who underwent palliative surgical resection received chemotherapy plus radiotherapy, the remaining 4 patients died of operative complications during surgery. The overall 1-, 3- and 5-year survival rate of this series was 81.5%, 51.9% and 22.2% , respectively. In the radical resection group, it was 15.8% for the patients received radiotherapy alone versus 75.0% for those treated by chemotherapy plus radiotherapy. The 5-year survival rate was 33.3% for the patients without extra-esophageal infiltration and 33. 3% for the patients without lymph node metastasis, respectively. However, it was only 9. 1% for the patients with extra-esophageal infiltration and 14.3% for those with lymph node metastasis, respectively. For the patients who had palliative surgical resection, though they received chemotherapy plus radiotherapy postoperatively, none of them survived longer than 5-year. Statist
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2007年第6期470-473,共4页
Chinese Journal of Oncology
