375例食管癌三维适形放疗长期疗效分析  

Analysis the long.term effect of 375 patients with esophageal carcinoma treated by three-dimensional conformal radiotherapy

作　　者：李娟[1] 祝淑钗[1] 王玉祥[1] 刘志坤[1] 沈文斌[1] 苏景伟[1] 

机构地区：[1]河北医科大学第四医院放疗三科,石家庄050011

出　　处：《中华放射肿瘤学杂志》2012年第4期334-338,共5页Chinese Journal of Radiation Oncology

基　　金：河北省普通高等学校肿瘤学强势特色学科建设项目（冀教高[2005]52号）;河北省医学适用技术跟踪项目（GL200848）;河北省卫生厅科研资助项目（09149）

摘　　要：目的分析食管癌三维适形放疗（3DCRT）的长期疗效及其预后影响因素。方法回顾分析2001--2006年首程接受3DCRT的375例食管癌患者的临床资料，其中I期9例、Ⅱ期106例、Ⅲ期158例、Ⅳ期102例。观察近期疗效、局部控制率、生存率。采用Kaplan—Meier法计算局部控制率和生存率等，预后影响因素行Logrank法单因素分析和Cox法多因素分析。结果随访率为94．7％，随访满5年者191例。全组1、3、5年局部控制率分别为80．5％、53．7％、44．9％，生存率分别为67．2％、29．4％、19．0％。单因素预后分析显示疗前进食情况、肿瘤长度、病变横径、T分期、N分期、临床分期、急性放射性食管炎、急性放射性肺炎为影响因素（X2=46．75、18．52、30．24、42．53、32．71、75．68、7．13、4．64，P=0．000、0．000、0．000、0．000、0．000、0．000、0．008、0．031），多因素预后分析显示肿瘤长度、临床分期、应用化疗、急性放射性食管炎为影响因素（x。=6．70、18．00、4．87、1．18，P=0．030、0．000、0．027、0．011）。结论食管癌3DCRT后局部控制率有所提高，但长期生存改善并不明显；肿瘤长度、临床分期、应用化疗和急性放射性食管炎为预后影响因素。Objective To analyze the outcomes and prognostic factors of advanced esophageal carcinoma treated by three-dimensional conformal radiotherapy （3DCRT）. Methods From Jul 2001 to Dec 2006. 375 patients with esophageal carcinoma treated by 3DCRT were retrospectively analyzed of which I stage 9, II stage 106, m stage 158, IVstage 102. The short-term effect, 1-,3-,5-year local regional control rates and survival rates were investigated. The local regional control rates and survival rate were calculated by the Kaplan-Meier method. Univariate prognostic factor was analyzed by Logrank method. Multivariate prognostic factor was analyzed using Cox regression model. Results The follow-up rate was 94. 7%. The numbers of patients followed-up with 5 years was 191. The 1-,3-and 5-year local control rates were 80. 5%, 53.7%, 44. 9% respectively. The 1-, 3-and 5-year survival rates were 67.2%, 29.4%, 19.0% respectively. Univariate analysis showed the significant prognostic factors included the degree of dysphagia, tumor length, the largest diameter of lesion in CT image, T stage, N stage, clinical TNM stage, grades of acute radiation-induced esophagitis and grades of acute radiation-induced pneumonery （X2 = 46. 75,18.52, 30. 24,42. 53,32. 71,75.68,7.13,4. 64,P = 0. 000,0. 000,0. 000,0. 000,0. 000,0. 000,0. 008,0. 031 ）. Multivariate analysis revealed tumor length, clinical TNM stage, chemotherapy and grades of acute radiation- induced esophagitis were independent prognostic factors （ X2 = 6. 70,18.00,4. 87,1.18, P = 0. 030,0. 000, 0. 027,0. 011 ）. Conclusions 3DCRT is effective and feasible in treatment of the advanced esophageal carcinoma. Tumor lesion length, clinical TNM stage, chemotherapy and grades of acute radiation-induced esophagitis are independent prognostic factors for survival of patients.

关 键 词：食管肿瘤/放射疗法 放射疗法 三维适形 预后 

分 类 号：R734.2[医药卫生—肿瘤]