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食管癌恶性度高,手术治疗仍是其治疗主要手段,即使行广泛三野淋巴引流区域清扫仍有较高复发比例。对于局部晚期、淋巴结转移或伴有其他不良预后因素者术后放疗可以降低胸腔内复发,提高部分患者生存率。然而,多组关于术后预防性放射治疗的前瞻性研究均显示放疗范围不统一。胸段食管癌根治术后主要的复发部位为上纵隔淋巴结区和锁上淋巴结区,影响其复发的因素主要包括手术术式、肿瘤部位、肿瘤侵犯深度、术后淋巴结是否转移以及转移数量等。根据食管癌根治术后的复发规律合理进行术后放射治疗的靶区设计,对提高食管癌根治术后患者的局控率,进而改善生存率具有重要的临床意义。
Malignant esophageal cancer, surgical treatment is still the main method of treatment, even if the line of extensive lymphadenectomy area still has a higher recurrence rate. For locally advanced, lymph node metastasis or associated with other adverse prognostic factors postoperative radiotherapy can reduce intrathoracic recurrence and improve the survival rate of some patients. However, many prospective studies on postoperative prophylactic radiotherapy have shown that the radiotherapy range is not uniform. The main recurrence sites of thoracic esophageal cancer after radical resection were the upper mediastinal lymph node region and the locked lymph node region. The main factors affecting the recurrence of thoracic esophageal cancer include operative procedure, tumor location, depth of tumor invasion, lymph node metastasis and metastasis. According to the recurrence of esophageal cancer after radical resection of the rule of reasonable postoperative radiotherapy target design, to improve the control rate of patients with esophageal cancer after radical surgery, thereby improving the survival rate has important clinical significance.