Clinical value of prophylactic radiotherapy after curative resection of esophageal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the clinical value of prophylactic radiotherapy for esophageal carcinoma after curative operation.</p><p><b>METHODS</b>495 esophageal squamous cell cancer patients who had undergone radical resection were randomized by the envelope method into a surgery alone group (S, 275) and a surgery plus radiotherapy group (S + R, 220). Radiation treatment was started 3 - 4 weeks after operation. The portals encompassed the whole mediastinum and bilateral supraclavicular areas. A mid-plane dose of 50 approximately 60 Gy in 20 approximately 30 fractions over 5 approximately 6 weeks was delivered.</p><p><b>RESULTS</b>1. Survival rate: the overall 5-year survival rate was 39.4%. Those of S alone and S + R groups were 37.1% and 41.3% (P = 0.447 4). The 5-year survival rate for Stage III patients were 13.1% in S alone group and 35.1% in R + S group (P = 0.002 7), 2. Pattern of failure: The incidence of local recurrence intra-thoracic lymph node metastasis, anastomotic recurrence and extra-thoracic lymph node metastasis in S + R group (16.2%, 0.5% and 3.1%) were lower than those (25.9%, 5.8% and 13.2%) (P < 0.05) in S alone group and 3.</p><p><b>COMPLICATIONS</b>the anastomotic stricture frequencies were similar in the two groups (S 1.8%; S + R 4.1%).</p><p><b>CONCLUSION</b>1. Prophylactic radiotherapy is able to improve the survival rate of stage III patients treated by radical resection, 2. Postoperative radiotherapy is able to reduce the incidence of failure by recurrence in the intra-thoracic lymph nodes and anastomotic recurrence to where radiation therapy had been given, 3. Postoperative radiotherapy does not increase the incidence of anastomotic stricture.</p>

VALUE OF RADIOTHERAPY AFTER EXPLORED OPERATION FOR ESOPHAGEAL CANCER / 中华放射肿瘤学杂志

The prognosis is very poor for the patients with advanced esophageal cancer proved by explored operation.There was not concurrent for the value of radiotherapy after explored operation.A series of 104 patients with explored operation alone and 155 patients with radiotherapy before or after explored operation were analyzed to evaluation the value of postoperetive radiotherapy. The results showed: (1) Postoperative radiotherapy was effective for the patients with advanced esophageal cancer after explored operation.The average survival/mean survival and 1～5 years survival were higher in the patients with postoperative radiotherapy than in those of operation alone. (2) ≥6000cGy groupe was better than

CAUSE OF FAILURE AND POSTOPERATIVE RADIOTHERAPY FOR STAGE Ⅰ AND Ⅱ_A ESOPHAGEAL CARCINOMA TREATED BY RADICAL RESECTION / 中华放射肿瘤学杂志

From January 1977 to December 1988, 279 cases of esophageal carcinoma were proved to be stage Ⅰ andⅡ A after operation. Within 5 years of the operation, 103 cases have failed. The failure was closely related to TNM stages. The regional and esophageal bed failure were obviously related to the site of the original lesion. Twelve of these 279 patients recieved postoperative radiotherapy. The incidence of intra-portal recurrence was lower in those who received postoperative radiotherapy than those who did not, although hematogenous metastasis was similar in these two groups. The 5-year survival rate with no evidence of cancer was higher in patients who received postoperative irradiation.