The Clinical Research Of The Role And The Optimal Timing Of Postoperative Radiotherapy For Stage ? Or Lymph Node Positive Esophageal Carcinoma

Objective:To clarify the role of adjuvant radiotherapy in the treatment of III stage or lymph node positive esophageal cancer after radical resection of esophageal cancer,to explore the optimal timing of postoperative radiotherapy,and to analyze the related prognostic factors,so as to provide reference and basis for the clinical treatment of esophageal carcinoma.Methods:We collected the clinical data of 204 cases of patients who suffered from esophageal carcinoma were treated with radical resection and its clinical stage was proved Stage III or lymph node positive after sugery in the Shanxi provincial tumor hospital and the second hospital of Shanxi Medical University from January 2010 to December 2015.Treatment method:80 cases of simple radical operation group,84 cases of postoperative adjuvant radiotherapy group,40 cases of postoperative adjuvant chemoradiotherapy group.Radiotherapy intervention time:71 cases of early intervention group,53 cases of late intervention group.Radiotherapy dose:the total dose<45Gy were 24 cases,the total dose of 45-50Gy were 70 cases,the total dose>50Gy were 30 cases.The statistics were analysised by SPSS20.0 statistical software.Results:The median survival time of the postoperative radiotherapy group and the si mple operation group was 31.2 months and 17.4 months,respectively,and the 1-,3-,5-year survival rates of the two groups were 82.8%,43.7%,32.4%and 61%,26.8%,20.5%,respectively,c~2=6.861,P=0.009.Stratified analysis showed the median sur vival time of the early radiotherapy intervention group and the late radiotherapy i ntervention group was 40.6 months and 30.4 months,respectively,and the 1-,3-,5-ye ar survival rates of the two groups were 88.4%,48.1%,44.3%and 72.1%,36.9%,26.4%,respectively.Compared with the late radiotherapy intervention group,the early radiotherapy intervention group could significantly prolong the survival time of t he patients(P<0.05).The median survival time of the three different doses of radi otherapy group was 30.2 months,42 months and 37.4 months,respectively,and the 1-,3-,5-year survival rates were 80.6%,41.3%,27.5%;90.7%,58.3%,43.9%and 77%,45.2%,22.6%,respectively,the survival time of patients who receive radiotherapy dose of 45-50Gy was significantly higher than that of the other two groups,the differe nce was statistically significant(P<0.05),while there was no significant difference i n the survival rate between the two groups of dose less than 45Gy and dose grea ter than 50Gy(P=0.848).Conclusion:For patients with locally advanced esophageal cancer who have undergone radical resection and postoperative pathological stage is stage III or lymph node positive,postoperative radiotherapy can prolong the median survival time and increase the 1-,3-,5-year survival rates.The optimal timing of radiotherapy is within 3 months after operation,and the patients who receive radiotherapy dose of 45-50Gy have the best prognosis.