131例食管鳞癌三维适形放疗预后因素分析  

Analysis of treatment outcome and prognostic factor with three-dimensional conformal radiotherapy for thoracic esophageal squamous cell carcinoma

作　　者：万欣[1] 乔学英[1] 王雅棣[1] 高献书[2] 宋玉芝[1] 王薇[1] 

机构地区：[1]河北医科大学第四医院放疗科,石家庄050011 [2]北京大学第一医院放疗科,100034

出　　处：《中华放射肿瘤学杂志》2011年第3期202-204,共3页Chinese Journal of Radiation Oncology

基　　金：河北省卫生厅医学科学研究重点课题项目（07290）;河北省普通高等学校强势特色学科资助项目（2005-52）

摘　　要：目的探讨影响食管磷癌放疗的预后因素。方法回顾分析2004—2007年本科非手术并采用CT模拟定位及三维适形放疗的131例Ⅰ～Ⅲh期食管磷癌患者资料和影响预后因素。放疔采用6MVX线，靶区剂量60Gy分30次6周完成。结果随访率为100％。单因素分析结果显示原发灶大体肿瘤体积（GTV）≤40cm3和〉40cm3的1、2、3年局部控制率分别为71％、64％、60％和43％、32％、28％（x。=13．16，P=0．000）。T1＋2期和B期及T4期的分别为67％、59％、59％和62％、53％、50％及41％、28％、19％（x2=13．25，P=0．001）。GTV≤40cm3和〉40cm。的1、2、3年生存率分别为78％、53％、46％和45％、27％、7％（x2=21．55，P=0．000），T1＋2期和L期及T。期的分别为71％、50％、39％和68％、45％、25％及36％、18％、15％（x2=14．35，P=0．001），原发灶肿瘤长度≤5cm和〉5cm的分别为75％、50％、44％和53％、35％、18％（x2=5．99，P=0．014）。多因素分析结果显示GTV、T分期均影响局部控制率（X2=7．07，P=0．008；x2=6．63，P=0．036），而生存率仅与GTV有关（x2=15．82，P=0．000）。结论食管鳞癌GTV可作为显著影响预后的独立因素，GTV越大者预后越差。Objective To evaluate the impact of gross tumor volume （GTV） on prognosis of threedimensional conformal radiotherapy （3DCRT） in esophageal carcinoma. Methods From Jan. 2004 to Oct. 2007, 131 stage Ⅰ～Ⅲb patients with unreseetable esophageal carcinomas who received 3DCRT with 60 Gy/ 30f/6w were analyzed retrospectively. The effectiveness of related prognostic factors on survival was evaluated by univariate and multivariate analyses. Results The following-up rate was 100%. By univariate analysis, the 1-, 2-and 3-year local tumor control rates were 71% , 64% and 60% for patients with GTV volume ≤ 40 cm3 , and 43 % , 32% and 28 % for those with GTV volume 〉 40 cm3 （ X2 = 13. 16, P = 0. 000 ） , respectively. The 1-, 2-and 3-year local tumor control rates were 67% ,59%, 59% for T1＋2 patients, 62%, 53% , 50% for T3 patients, and 41% ,28% , 19% for T, patients, respectively （ X2 = 13.25,P = 0. 001 ）. The 1-, 2-and 3-year survival rates were 78% ,53% ,46% for patients of GTV volume≤40 cm3 and 45% , 27% and 7% for patients of GTV volume 〉40 cm3 （ X2 = 21.55 ,P =0. 000）. The 1-, 2-and 3-year survival rates were 71% ,50% and 39% for patients with T1＋2, 68% ,46% and 25% with Y3 , and 36% ,18% and 15% with T4, repeetively （ X2 = 14. 35, P = 0. 001 ）. The 1-, 2-and 3-year survival rates for patients with tumor length≤5 cm were 75% ,50% and 44% , compared with 53% ,35% and 18% with tumor length 〉5 cm （X2= 5.99, P= 0.014）. By muhivariate analysis, GTV volume and T stage were likely to be independent prognostic factors for local tumor control rates （ X2 = 7.07, P = 0. 008 ; X2 = 6. 63, P = 0. 036 ）. Only the GTV volume was associated with the overall survival rate （ X2 = 15.82, P = 0. 000）. Conclusions GTV volume is independent prognostic factor. The larger the GTV volume is, the worse the prognosis will be.

关 键 词：食管肿瘤/放射疗法 放射疗法 三维适形 预后 

分 类 号：R735.1[医药卫生—肿瘤]