Fok M, Law S Y, Wong J
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Ann Thorac Surg. 1994 Nov;58(5):1415-8. doi: 10.1016/0003-4975(94)91926-7.
Tracheobronchial recurrence occurred in 55 of 559 patients (9.8%) after resection of their esophageal carcinomas and in 22 of 109 patients (20.2%) after a bypass operation. The risk of airway recurrence increases if residual disease is present in the mediastinum at resection. The median survival of 55 patients diagnosed with tracheobronchial recurrence before July 1988 was 3.7 weeks. After July 1988, there were 22 patients in whom tracheobronchial recurrence developed, 19 of whom were treated by neodymium:yttrium-aluminum-garnet laser under local anesthesia. Additional external radiotherapy was offered to 8 patients who responded to laser treatment and were in satisfactory condition. Four of these patients (21%) had complete tumor regression. Partial regression occurred in 7 patients (37%): 2 were treated by combined therapy and 5 by laser alone. Most tolerated the laser treatment well, but the procedure was abandoned in 6 patients because of smoke inhalation. A tracheoesophageal fistula developed in 2 patients. The median survival for the entire group was 7.4 weeks, with 3 long survivors who lived more than 1 year. The combined application of laser and external radiotherapy is effective for the treatment of tracheobronchial recurrences in patients with esophageal carcinoma.
559例食管癌患者术后有55例（9.8%）发生气管支气管复发，109例旁路手术后有22例（20.2%）发生气管支气管复发。如果切除时纵隔存在残留病灶，气道复发风险会增加。1988年7月前诊断为气管支气管复发的55例患者的中位生存期为3.7周。1988年7月后，有22例患者发生气管支气管复发，其中19例在局部麻醉下接受了钕钇铝石榴石激光治疗。另外8例对激光治疗有反应且状况良好的患者接受了体外放疗。这些患者中有4例（21%）肿瘤完全消退。7例（37%）部分消退：2例接受联合治疗，5例仅接受激光治疗。大多数患者对激光治疗耐受性良好，但6例患者因吸入烟雾而放弃治疗。2例患者发生气管食管瘘。整个组的中位生存期为7.4周，有3例长期存活者存活超过1年。激光与体外放疗联合应用对食管癌患者气管支气管复发的治疗有效。
