93例可手术切除食管癌三维适形放疗长期生存分析  

Three-dimensional conformal radiotherapy of early stage esophageal carcinoma

作　　者：沈文斌[1] 祝淑钗[1] 李娟[1] 苏景伟[1] 刘志坤[1] 李幼梅[1] 

机构地区：[1]河北医科大学第四医院放疗科,石家庄050011

出　　处：《中华放射肿瘤学杂志》2011年第1期32-35,共4页Chinese Journal of Radiation Oncology

基　　金：基金项目：河北省卫生厅资助项目（07113）

摘　　要：目的 分析临床可切除食管癌三维适形放疗的长期疗效和副反应及治疗失败原因,并与同期手术治疗患者结果进行比较.方法 回顾分析93例接受三维适形放疗的可切除食管癌患者,采用6 MV X线直线加速器放疗50～70 Gy.对影响患者预后因素进行单、多因素分析,并分析死亡原因.分析同期93例手术治疗患者治疗结果.结果 放疗组随访满1、3、5年者分别为79、42、13例,随访率为100%.1、3、5年总生存率分别为84%、50%、29%,局部控制率分别为83%、63%、55%,无瘤生存率分别为83%、49%、28%,无远处转移生存率分别为84%、51%、28%.单因素分析显示患者年龄、疗前进食状况、疗前有无胸背部疼痛、病变部位、X线病变长度、CT扫描显示病变最大侵袭深度、近期疗效及未行手术原因与预后相关,多因素分析显示患者年龄、疗前有无胸背部疼痛、病变部位、X线病变长度是独立预后因素.局部复发和远处转移仍为患者主要死亡原因.手术组随访满1、3、5年者分别为80、46、16例,随访率为100%.1、3、5年总生存率分别为86%、62%、41%,中位生存期47.8个月.结论 三维适形放疗可切除食管癌能取得较好疗效,可作为其治疗方法之一.Objective To analyze the result of3-dimensional conformal radiotherapy（3DCRT）and operation of early stage esophageal carcinoma. Methods Ninety-three patients with early stage esophageal carcinoma were treated with 3DCRT from October 2000 to December 2006. The total dose was 50 -70 Gy/25 -35F/5 -7 w. Toxicities and survival rates were evaluated by Kaplan Meier method and the factors of death were analyzed. Results In the 3DCRT group, 79, 42 and 13 cases were followed up for at least 1-,3-,and 5-year, respectively. Follow-up rate was 100%. The 1-, 3-, and 5-year actuarial survival rates were 84% ,50% and 29%, respectively, with a median survival time of 37.0 months. The 1-, 3-, and 5-year local control rates were 83% ,63% and 55% ,respectively. The 1-, 3-, and 5-year disease free survival rates were 83% ,49% and 28%, respectively. The 1-, 3-, and 5-year metastasis free survival rates were 84%,51% and 28%, respectively. There were significant influence on the prognosis of age, the state of food taken before treatment, the pain of chest and back, the disease region, the tumor length in x-ray, the maximuminfiltration depth in CT scan, the preliminary curative effect and the no operation in univariate analysis. The Cox multivariate model showed that age, the pain of chest and back, the disease region and the tumor length in X-ray were independent prognostic factors. In the operation group, 80,46 and 16 cases were followed up for at least 1-,3-,and 5-year, respectively. Follow-up rate was 100%. The 1-, 3-, and 5-year actuarial survival rates were 86% ,62% and 41%, respectively, with a median survival time of 47.8 months. Conclusion Three-dimensional conformal radiotherapy is one of the best radiation treatment regimen for early esophageal carcinoma.

关 键 词：食管肿瘤/三维适形放射疗法 食管肿瘤/外科学 预后 

分 类 号：R735.1[医药卫生—肿瘤]