Evaluation of the value of postoperative radiotherapy for esophageal squamous cell carcinoma based on the patterns of failure after right thoracotomy
10.3760/cma.j.cn113030-20220527-00143
- VernacularTitle:食管鳞癌右胸径路开放术后治疗失败模式与放疗价值评估
- Author:
Linmeng LIU
1
;
Jian LIANG
;
Chun HAN
;
Qi WANG
;
Lan WANG
Author Information
1. 河北医科大学第四医院放疗科，石家庄 050011
- Keywords:
Esophageal neoplasms;
Right thoracotomy;
Surgery;
Failure pattern;
Postoperative radiotherapy
- From:
Chinese Journal of Radiation Oncology
2022;31(12):1168-1173
- CountryChina
- Language:Chinese
-
Abstract:
The current recommendation for postoperative radiotherapy for esophageal cancer in China is mainly based on the data of incomplete two-field dissection of the left thoracotomy (category 2B evidence). However, the surgery of esophageal cancer is undergoing a period of transformation, which has gradually transitioned from left thoracotomy to right thoracotomy, and from open surgery to minimally invasive surgery. Compared with incomplete two-field dissection of left thoracotomy, complete two-field / cervical thoracic and abdominal three-field dissection of right thoracotomy could more thoroughly dissect the upper mediastinum and cervical lymph nodes. Hence, theoretically, it yields a lower recurrence rate of regional lymph nodes and prolongs the survival time. However, under the new technical conditions, whether the tumor recurrence pattern and recurrence rate after esophageal cancer surgery will change significantly compared with the past, whether postoperative radiotherapy still has the value of local control and survival benefits, and whether the indications of postoperative radiotherapy need to be adjusted accordingly have not been determined. Based on the above considerations, the changes in surgical methods for esophageal cancer at the current stage, the survival status of right thoracotomy and postoperative patterns of failure were summarized, aiming to evaluate the value of adjuvant radiotherapy under the condition of right thoracotomy.
