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目的:观察食管鳞癌放疗后复发再治疗的近期疗效。方法:65例经病理证实复发接受并完成治疗。32例1年内复发者为A组,33例1年后复发者为B组。均先行化疗两个周期。NP方案:34例,A组16例,B组18例,NVB25mg·m-2ivdrip第1、8天,DDP30mg·m-2ivdrip第1～3天,常规水化。DF方案:31例,A组16例,B组15例,DDP同前,CF200mg,FT-2071000mgivdrip每日1次,连用5天。均21天一个周期。两个周期后放疗。B组33例,先予6MV-X线,适形照射DT30Gy·3周-1,再行后装治疗DT5Gy(次·周)-1,连续4～6周。A组32例直接作后装治疗,方法同前。19例锁骨上淋巴结转移者,局部照射DT60～70Gy。结果:总有效率41.5%。A组再治疗有效率28.1%低于B组54.5%。NP有效率44.1%优于DF38.7%。全组1、2年生存率分别为27.7%、15.3%;A与B组分别为15.6%、3.1%与39.4%、27.3%;NP与DF分别为32.3%、20.6%与22.6%、9.7%。A组副作用高于B组。结论:食管癌放疗后复发,只要条件允许,不应轻易放弃治疗,特别是1年后复发者。在放疗前建议使用NP方案。长期疗效有待观察。
Objective: To observe the short-term effect of recurrence and re-treatment of esophageal squamous cell carcinoma after radiotherapy. Methods: 65 cases were confirmed by pathology confirmed the recurrence and complete treatment. 32 cases of recurrence within 1 year for the A group, 33 cases of recurrence after 1 year for the B group. Both chemotherapy two cycles. NP regimen: 34 cases, group A 16 cases, group B 18 cases, NVB25mg · m-2ivdrip days 1 and 8, DDP30mg · m-2ivdrip days 1 to 3, conventional hydration. DF program: 31 cases, 16 cases in group A, 15 cases in group B, DDP with the former, CF200mg, FT-2071000mgivdrip once daily for 5 days. All 21 days a cycle. Two cycles after radiotherapy. In group B, 33 cases were treated with 6MV-X ray first, DT30Gy · 3 weeks -1 after conformal irradiation, and then DT5Gy -1 (after · weeks) -1 after loading for 4 ~ 6 weeks. A group of 32 cases directly after the treatment, the same way. 19 cases of supraclavicular lymph node metastasis, local irradiation DT60 ~ 70Gy. Results: The total efficiency of 41.5%. The re-treatment efficiency of group A was 28.1% lower than that of group B 54.5%. NP efficiency of 44.1% is better than DF38.7%. The 1- and 2-year overall survival rates were 27.7% and 15.3% in the group A and B respectively 15.6%, 3.1% and 39.4% and 27.3% respectively; NP and DF were 32.3%, 20.6% and 22.6%, 9.7% . Side effects in group A were higher than those in group B. Conclusion: Esophageal cancer relapse after radiotherapy, as long as the conditions permit, should not give up treatment, especially one year after recurrence. NP is recommended before radiotherapy. Long-term efficacy remains to be seen.