N0期胸段食管癌GTV长度和最大直径及体积对放疗预后影响  

The effect of tumor length, maximum diameters and volume on the response of NO stage thoracic esophageal squamous cell carcinoma

作　　者：苏娜[1] 王雅棣[1] 李成林[2] 孙冉[2] 刘青[2] 程云杰[2] 

机构地区：[1]北京军区总医院放疗科,100700 [2]河北医科大学第四医院放疗科

出　　处：《中华放射肿瘤学杂志》2014年第1期27-30,共4页Chinese Journal of Radiation Oncology

摘　　要：目的评价食管癌GTV长度、最大直径和体积对放疗预后影响。方法选取2004--2008年河北医科大学第四医院和北京军区总医院放疗科收治的Nn期胸段食管癌患者72例，分析GTV长度、最大直径、体积对放疗近期疗效和远期生存的影响。结果GTV长度〈5、5～7、〉7cm组甲级率和5年生存率均不同，分别为79％、48％、26％（P=0．003）和69％、46％、22％（P=0．037）。肿瘤最大直径≤3cm组甲级率和5年生存率高于〉3cm组，分别为56％、33％（P=0．033）和37％、30％（P=0．037）。肿瘤体积≤40cm3组有效率和5年生存率高于肿瘤体积〉40cm3组，分别为52％、30％（P=0．059）和41％、27％（P=0．047）。多因素分析显示长度是影响近期疗效与预后的主要因素（P：0．005、0．014）。结论N0期胸段食管癌肿瘤长度、最大直径与体积对放疗近期疗效和生存率有不同程度影响，其中肿瘤长度是影响近期疗效与远期生存的主要因素。Objective To evaluate the effect of GTV volume on response of carcinoma. Methods From Jan. 2004 to Dec. 2008, 72 cases newly diagnosed No stage thoracic esophageal esophageal carcinomas were included in this retrospective study. All treatment plans were set up and designed by CT simulator and 3D TPS. They received dose 56-70 Gy/27-33F/6-7w with 6MV X-ray. The GTV, the tumor length and maximum diameters were measured on the treatment planning system with the X-ray. RECIST standard was applied to evaluate the radiotherapy response of esophageal carcinoma The effectiveness of related prognostic factors on survival was evaluated by univariate analyses. Results The short-term response with CR were 79% with length 〈 5 cm, 48% with 5-7 cm and 26% with length 〉7 cm（P =0. 003）. The 1-, 2-,3- and 5-year survival rates were 93%, 79%, 69%, 69% ; 91%, 61%, 46%, 46% and 80%, 46%, 28%, 22% （ P = 0. 037 ）. The short-term response with CR were 56% with maximum diameters ≤3 cm and 33% with maximum diameters 〉 3 cm（P = 0. 033）. The 1- , 2- ,3- and 5-year survival rates were 91% ,72% ,55% ,37% and 80% ,45% ,30% ,30% （P = 0. 037）. The short-term response with CR were 52% with GTV volume≤40 cm3 and 30% with GTV volume 〉40 cm3（P =0.059）. The 1-, 2-,3- and 5-year survival rates were 91% ,67% ,51% ,41% and 80% ,43% ,27%, 27% （P = 0. 047）. In the multivariate analysis, the length of GTV was likely to be the most important factor for the short-term response（P = 0. 005,0. 014）. Conclusions GTV volume, the tumor length and maximum diameters are factors for short-term response of No stage esophageal carcinoma. The GTV length is independent prognostic factor. The GTV length 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]