Abstract: Objective To compare and analyze the effect of different irradiation field for postoperative lower thoracic esophageal carcinoma on survival rate, and compare toxicities of two groups. Methods We retrospectively analyzed 103 patients who underwent radical resection of lower thoracic esophagus carcinoma and had postoperative radiotherapy indication. Patients were devided into two groups, the extensive portal group and the regional portal group. All the patients underwent postoperative radiation four weeks after surgery. The radiation dose was from 45 to 54 Gy, and the medium was about 50 Gy. Results Grade≥2 gastrointestinal reactions in the regional group was significantly lower than that of the extensive group, with a statistically significant difference(P<0.05). For the entire group, the 1, 3 and 5 years survival rate of whole cases was 91.3%, 50.5%, 32.0% respectively. The 1, 3 and 5 years survival rate of the extensive group was 91.2%, 49.1%, 31.6% respectively, and 91.3%, 52.2%, 32.6% respectively in the regional group (not significant). Conclusion Using a regional portal in postoperative RT for lower esophageal carcinoma is not associated with compromised survival compared with extensive portal RT and adverse reactions were well tolerated.

Key words: esophageal neoplasms/postoperative radiotherapy, irradiation field, toxicities, survival rate

摘要： 目的 比较和分析胸下段食管癌术后预防性放疗照射野范围大小对生存率的影响,并比较两组的毒副反应。方法 回顾性分析在我院行胸下段食管癌根治术并具有术后放疗指征的患者103例,分别为大野组和小野组,均于术后4周左右开始放疗,总剂量45~54Gy,中位剂量50Gy左右。结果 术后放疗小野组≥2级胃肠道副反应的发生率低于大野组,两组比较差异有统计学意义(P<0．05)。全组病例1年、3年、5年生存率分别为91.3%,50.5%,32.0%,大野组分别为91.2%,49.1%,31.6%,小野组分别为91.3%,52.2%,32.6%,差异无统计学意义。结论 胸下段食管癌根治术后预防照射时,适当缩小照射野不会降低生存率,且副反应耐受良好。

关键词: 食管肿瘤/术后放射疗法, 照射野, 不良反应, 生存率