The Curative Effect Of Postoperative Radiotherapy Dose For The Patients Of Esophageal Squamous Cell Carcinoma (ESCC)

Objective:To investigate the effect of postoperative radiation dose of esophageal squamous carcinoma on clinical efficacy,It is helpful to choose more appropriate postoperative radiotherapy dose to improve the survival rate of patients.Method:This study collected 103 cases of esophageal squamous carcinoma postoperative patients in November 2011-December 2016 from nanchong central hospital.All patients with pathological stage at T₃N_0-3M₀received intensity modulated radiation therapy.According to the prescription dose,they were divided into A and B groups,Group A<50Gy/25F（38 cases）;Group B≥50Gy/25F（65 cases）.Using SPSS 22.0 software processed the data,P<0.05 was considered as statistical significance.Result:The univariate and multivariate analysis showed that radiotherapy dose was the prognostic factor of esophageal squamous cell carcinoma.1.All patient’s the median DFS was 20 months,OS was 29 months,the1,2,3 year DFS rates were 69.9%,39.1%,37.1%and the 1,2,3 year OS rates were 89.2%,61.6%,45.2%.2.The 1,2,3 year DFS rates of the group A were 53.6%,16.7%,11.2%and the 1,2,3 year OS rates were 82.1%,36.7%,18.3%,with the median DFS was 13 months and OS was 19 months;Meanwhile,the 1,2,3 years DFS rates of the group B were 76.6%,51.6%,48.6%and 1,2,3 year OS rates were92.3%,73.0%,55.3%,with the median DFS was 27 months and the OS was 43months（P<0.001,P<0.001）.3.The DFS and OS in the post-op negative group were superior to the lymph nodes（P<0.001,P<0.001）.The effects of radiotherapy dose on DFS and OS were analyzed according to the presence of lymph nodes,in the positive group of lymph node metastasis,the effect of<50Gy and≥50Gy on the DFS was not significant（P=0.114）,but the effect on OS was significant（P=0.039）.In the negative group,the patients received<50Gy and≥50Gy exposure had significant influence on DFS and OS（P<0.001,P<0.001）;4.The radiotherapy related toxicological analysis revealed that the acute upper gastrointestinal reaction and acute radiation pneumonia in group B were more severe than group A（P=0.029,P<0.001）.Conclusion:1.The patients of esophageal squamous cell carcinoma with radiation dose≥50Gy had better survival benefit whatever the lymph node stage.2.The post-op radiation dose was an independent factor that affects the patients’DFS and OS of esophageal squamous cell carcinoma.3.The postoperative radiotherapy dose≥50Gy will lead to increased risk in patients with acute radiation injury.