110例N1期食管鳞癌术后辅助治疗疗效分析  

Efficacy of adjuvant therapy in 110 patients with N1 lymph node metastasis of esophageal squamous cell carcinoma

作　　者：邵国光[1] 郭晔[2] 王星星[2] 张宏[1] 崔有斌[1] 梁婷婷[2] 马克威[2] 

机构地区：[1]吉林大学白求恩第一医院胸外科,长春130021 [2]吉林大学白求恩第一医院肿瘤中心,长春130021

出　　处：《中华肿瘤杂志》2016年第1期55-62,共8页Chinese Journal of Oncology

摘　　要：目的探讨N1阳性的食管鳞癌术后辅助治疗对患者预后的影响。方法2008年1月至2013年12月行根治性手术的N1阳性食管鳞癌患者110例。其中单纯手术组46例；术后辅助治疗组64例，术后辅助治疗组中单纯辅助化疗24例，同步放化疗40例。分析患者的无病生存时间（DFS）和总生存时间（0s），采用Cox比例风险模型分析影响患者预后的独立因素。结果单纯手术组和术后辅助治疗组患者的中位DFS分别为10．6和16．8个月，差异有统计学意义（P=0．007）。单纯手术组和术后辅助治疗组患者的中位OS分别为13．7和21．3个月，差异有统计学意义（P=0．001）。单纯手术组和术后辅助化疗组患者的中位OS分别为13．7和31．1个月，差异有统计学意义（P=0．002）。辅助化疗组和同步放化疗组患者的中位DFS分别为16．3和16．8个月，差异无统计学意义（P=0．346）。辅助化疗组和同步放化疗组患者的中位0s分别为23．4和21．3个月，差异无统计学意义（P=0．491）。Cox多因素分析显示，术后辅助治疗为影响N1阳性食管鳞癌患者预后的独立因素。结论N1阳性食管鳞癌患者根治术后应用辅助治疗可改善患者的预后、延长患者的生存时间。Objective The aim of this study was to evaluate the effect of postoperative adjuvant therapy on the survival in patients with N1 lymph node metastasis of esophageal squamous cell carcinoma （ESCC）. Methods 110 patients with positive N1 lymph node metastasis of esophageal squamous carcinoma were included in this study. The surgery group included 46 cases and the postoperative adjuvant therapy group included 64 cases （24 cases in the adjuvant chemotherapy subgroup and 40 cases in the adjuvant concurrent chemoradiotherapy）. The disease-free survival （DFS） and overall survival （OS） of the two groups were compared and the prognostic factors were analyzed by multivariate Cox model. Results In the postoperative adjuvant therapy group, the DFS （ 16.8 months） and OS （21.3 months） were significantly prolonged compared with those in the surgery group （ 10.6 months, P= 0.007） and （ 13.7 months, P = 0.001）, respectively. Postoperative adjuvant chemotherapy significantly extended the OS （31.1 months） of Nl-positive patients compared with 13.7 months （P = 0.002） in the surgery group. But there were no significant differences between the DFS in the two subgroups （ 16.3 and 16.8 months, P = 0.346 ） and between the OS （23.4 and 21.3 months, P = 0.491 ）. Postoperative adjuvant therapy was an independent prognostic factor in the ESCC patients with N1 lymph node metastasis. Conclusion Postoperative adjuvant therapy can improve the prognosis and prolong the survival time in ESCC patients with positive N1 lymph node metastasis.

关 键 词：食管肿瘤 癌 鳞状细胞 淋巴转移 肿瘤辅助疗法 

分 类 号：R735.1[医药卫生—肿瘤]