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目的确定术前放疗对贲门腺癌的作用。材料与方法１９７８年１月到１９８９年５月对贲门腺癌术前放疗的作用进行了前瞻性随机分组的研究，综合组１７１例，单纯手术组１９９例。年龄６５岁以下，进半流食以上，行为状态０～Ⅱ级，无手术禁忌证。术前放疗用８ＭＶＸ线或６０Ｃｏ照射贲门、食管下段、胃底、胃小弯和肝胃韧带等５个区域，前后两个对穿野总剂量ＤＴ４０Ｇｙ，照射４周２０次，休息２～４周，进行手术。结果综合组１～１０年生存曲线明显高于单纯手术组，两组５和１０年生存率分别为３０．１％、１９．８％；２０．３％、１３．３％（Ｐ＜０．０１），差异有显著性意义。综合组和单纯手术组的近期效果：切除率分别是８９．５％和７９．４％（Ｐ＜０．０１）；术后病理Ｔ分期中Ｔ２期分别为１２．９％和４．５％（Ｐ＜０．０１）；Ｔ４期为４０．３％和５１．３％（Ｐ＜０．０５）；淋巴结转移率为６４．３％和８４．９％（Ｐ＜０．００１）；手术死亡率为０．６％和２．５％；胸内吻合口瘘为１．８％和４．０％；切缘残癌４．７％和４．０％。综合组和单纯手术组的失败原因：局部未控复发率、腹腔内外淋巴结转移率和远处转移率分别为３８．６％和５１．７％（Ｐ＜０．０２５）；３８．６％?
Objective To determine the effect of preoperative radiotherapy on cardiac adenocarcinoma. Materials and Methods The role of preoperative radiotherapy for cardia adenocarcinoma from January 1978 to May 1989 was prospectively randomized, with 171 patients in the comprehensive group and 199 in the simple surgery group. Under the age of 65, entering semi-liquid food, behavioral status 0 to II, no surgical contraindications. Preoperative radiotherapy with 8MV-X or 60Co irradiation of the cardia, lower esophageal, gastric fundus, gastric curvature and hepatogastric ligament and other five areas, before and after the two pairs of wearing the total dose of DT40Gy, irradiation 4 weeks 20 times, rest 2 ~ 4 weeks, surgery. Results The survival curve of the comprehensive group from 1 to 10 years was significantly higher than that of the simple surgery group. The 5-year and 10-year survival rates of the two groups were 30.1% and 19.8%, respectively; 20.3% and 13.3% (P<0. 01) The difference has significant significance. The short-term effects of the combined group and the surgery alone group were 89.5% and 79.4%, respectively (P<0.01), and the postoperative pathological T stage was 12.9% and 4.5%, respectively. (P<0.01); T4 stage was 40.3% and 51.3% (P<0.05); lymph node metastasis rate was 64.3% and 84.9% (P<0.001); Mortality was 0.6% and 2.5%; intrathoracic anastomotic leakage was 1.8% and 4.0%; marginal residual cancer was 4.7% and 4.0%. The reasons for failure in the combined group and the surgery alone group were: local uncontrolled recurrence rate, intra-peritoneal lymph node metastasis rate, and distant metastasis rate were 38.6% and 51.7%, respectively (P<0.025); 38.6%?