摘要
目的探索胸段食管癌经左胸路径根治术后局部复发因素规律和影响因素，以及术后放疗靶区范围。方法回顾分析本院2009--2012年经左胸路径根治术后胸段食管癌局部复发患者的临床资料，分析局部复发规律及影响因素，并依此确定术后放疗靶区范围。结果共人组患者104例，术前病变位于胸上段14例、胸中段68例、胸下段22例。术后病理分期为T。期10例、T2期26例、L期56例、T4期12例；N0期48例、N1期56例；I期6例、Ⅱa期36例、Ⅱb期21例、Ⅲ期40例、M期1例。病理类型为鳞癌101例、腺癌2例、鳞癌小细胞癌？昆合型1例。局部复发时间为1～100个月（中位数12．8个月）。104例患者共发现局部复发部位136处。术后复发主要位于锁骨上、上中纵隔淋巴结（占83．8％），其中双侧锁骨上35例、上纵隔64例、中纵隔15例、腹腔9例、原瘤床4例、吻合口9例。放疗靶区应以双侧锁上区、中上纵隔及吻合口为主。结论胸段食管癌左胸路径术后局部复发位置主要在双侧锁上区、中上纵隔及吻合口，因此放疗靶区应包括上述范围。
Objective To investigate the pattern of local recurrence in patients with thoracic esophageal cancer （EC） who have received radical surgery through a left thoracotomy, its influential factors, and the clinical target volume （CTV） for postoperative radiotherapy. Methods A retrospective analysis was performed on the clinical data of 104 patients with thoracic EC who experienced local recurrence after radical surgery through a left thoracotomy from January 2009 to June 2012. The pattern of local recurrence and its influential factors were analyzed, and the CTV for postoperative radiotherapy was determined accordingly. Results Of the 104 patients, 14 had upper-thoracic EC, 68 had middle-thoracic EC, and 22 had lower- thoracic EC. According to UICC （2002） TNM classification, 10 of the patients had stage Tlb cancer, 26 had stage T2 cancer, 56 had stage T3 cancer, and 12 had stage T4 cancer;48 had stage NO cancer, and 56 had stage N, cancer;6 had stage I cancer, 36 had stage 1I, cancer, 21 had lib cancer, 40 had stage m cancer, and 1 had stage IVa cancer. In addition, 101 patients had squamous carcinoma, 2 had adenocarcinoma, and 1 had mixed squamous and small-cell carcinoma. The median time to local recurrence was 12. 8 months （1--100 months）. A total of 136 local recurrence sites were found in the 104 patients. Postoperative recurrence mainly occurred in the supraclavicular and upper/middle mediastinal lymph nodes （83.8%）. Of the 136 local recurrence sites, 35 were in the bilateral supraclavicular areas, 64 in the upper mediastinum, 15 in the middle mediastinum, 9 in the abdominal cavity, 4 in the original tumor bed, and 9 at the anastomosis. The CTV for postoperative radiotherapy should mainly include bilateral supraelavicular areas, upper/middle mediastinum, and anastomosis. Conclusions Local recurrence mainly occurred in the bilateral supraclavicular areas , upper / middle mediastinum , and anastomosis in patients with thoracic ECwho have received radical surgery through a left thoracotomy. Ther
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2013年第2期111-114,共4页
Chinese Journal of Radiation Oncology
关键词
食管肿瘤
外科学
肿瘤复发
食管肿瘤
放射疗法
靶区确定
Esophageal neoplasms/surgery
Neoplasm recurrence
Esophageal neoplasms/ radiotherapy
Target region delineation
