老年食管鳞癌根治性放化疗疗效观察及预后分析  

Outcomes and clinical prognostic factors for elderly patients with esophageal squamous cell carcinoma treated after definitive chemoradiotherapy

作　　者：吕博 陈赟 李云海[2] 朱虹[2] 赵快乐[1] 

机构地区：[1]复旦大学附属肿瘤医院放射治疗中心,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院闵行分院放疗科,上海200240

出　　处：《中国癌症杂志》2015年第3期217-221,共5页China Oncology

基　　金：国家自然科学基金(21172043)

摘　　要：背景与目的:随着人口的老龄化,≥70岁老年食管癌患者越来越多,然而对这部分患者的研究资料并不多,本研究评价老年食管鳞癌患者根治性放化疗疗效及相关预后因素。方法:回顾性分析2009年3月一2011年12月在复旦大学附属肿瘤医院放疗科接受根治性放化疗的年龄≥70岁的食管鳞癌初治患者治疗疗效及相关预后因素。结果:共53例符合条件的患者,中位年龄74岁;单纯放疗患者29例,同期放化疗患者24例;1、2、3和5年生存率分别为62%、44%、33%和19%;2度及以上急性放射性食管炎及放射性肺炎发生率分别为6%和9%,无一例患者发生4度及以上放射性损伤。COX多因素分析显示,治疗方式、病变部位以及吸烟史与患者的预后明显相关。结论:放疗能为老年食管鳞癌患者所耐受,是一种安全的治疗方式,同期化疗的参与能够提高患者治疗的疗效。Background and purpose： With the increase of aging population, elderly patients （age ≥70 years） with esophageal squamous cell carcinoma occurred more and more. However, few studies have focused on elderly esophageal squamous cell carcinoma patients. This study aimed to assess the outcomes and prognostic factors for elderly patients with esophageal squamous cell carcinoma treated after deifnitive chemoradiotherapy. Methods：We retrospectively analyzed 53 patients （age≥70 years） with esophageal squamous cell carcinoma and treated with deifnitive radiotherapy with or without chemotherapy from Fudan University Shanghai Cancer Center from Mar. 2009 to Dec. 2011. Results：Median age was 74 years. Twenty-nine patients underwent radiotherapy, 24 patients underwent radiochemotherapy. 1-, 2-, 3-, and 5- year survival was 62%, 44%, 33% and 19% respectively. Grade 2 and above acute radiation-induced esophageal toxicity and radiation pneumonitis occur rate was 6% and 9% respectively. No treatment-related deaths occurred and no patients experienced any grade 4 and above toxicities. Multivariate analysis identiifed treatment modality, tumor site and smoking history as independent prognostic factors for overall survival. Conclusion：Radiotherapy may be an acceptable treatment option for elderly patients with esophageal squamous cell carcinoma. In appropriately selected patients, concurrent chemotherapy could bring a better overall survival.

关 键 词：食管鳞癌 老年 预后 放化疗 

分 类 号：R735.1[医药卫生—肿瘤]