食管鳞癌放疗患者贫血现状及其对预后的影响研究  

Study on the Anemia Status among Patients with Esophageal Squamous Cell Carcinoma underwent Radiotherapy and Influence on Prognosis

作　　者：刘军[1] 晏军[1] 王越希 刘晓琴 赵倩 

机构地区：[1]自贡市第一人民医院肿瘤科,四川自贡643000

出　　处：《肿瘤预防与治疗》2017年第6期437-441,共5页Journal of Cancer Control And Treatment

基　　金：自贡市科技计划项目(编号:2014ZC12)

摘　　要：目的:分析食管鳞癌患者贫血现状并探讨放疗前贫血对食管鳞癌患者放射治疗预后的影响。方法:对2010年1月至2015年12月6年间自贡市第一人民医院收治的193例食管鳞癌放疗患者进行回顾性分析,根据放疗前血红蛋白水平分为贫血组和非贫血组,比较2组患者在放疗后第1、3、5年的生存率,采用Cox回归模型分析放疗前贫血对食管鳞癌患者预后的影响。结果:放疗前贫血患者89例(46.1%),中位Hb值98g/L(37~138g/L);放疗后贫血患者143例(74.1%),中位Hb值86g/L(34~130g/L)。放疗后患者贫血严重程度更高,差异有统计学意义(P<0.001)。临床分期、KPS评分、治疗前体重下降量、体重指数有关(P<0.05),肿瘤分期越晚、KPS评分越低、治疗前体重下降量越大、体重指数越低,则患者贫血发生比例越高。放疗前贫血组与非贫血组患者的1年、3年、5年的总生存率(OS)分别为78.9%、51.8%、30.1%和88.9%、68.8%、44.1%。非贫血组的中位生存时间明显高于贫血组,差异有统计学意义(χ2=4.989,P=0.026)。Cox回归分析显示,放疗前贫血是影响食管鳞癌患者放疗预后的独立危险因素(RR=2.581,P<0.05)。结论:食管鳞癌患者放疗前贫血发生率较高,放疗后贫血发生率及贫血程度进一步升高,且放疗贫血可影响患者的预后生存。Objective： To understand the anemia status among patients with esophageal squamous cell carcinoma underwent radiotherapy and to explore the influence on prognosis. Methods： 193 patients with esophageal squamous cell carcinoma treated with radiation therapy in YY Hospital from January 2010 to December 2015 were retrospectively ana- lyzed. The patients were divided into two groups according to hemoglobin levels before radiotherapy： the anemic group and non-anemic group. The survival rates of the 1st, 3rd, 5th year were compared between the anemic group and non-anemic group. The prognosis of patients with anemia were evaluated by Cox regression analysis. Results： Before radiotherapy, 89 patients （46.1%） had a median Hb of 98g/L （37 -138g/L）. After radiotherapy, 143 patients with anemia （74.1%）, the median Hb value of 86g/L （34 ~ 130g/L）. The severity of anemia was higher for patients after radiotherapy, and the difference was statistically significant （P 〈 0.001 ）. The clinical stage, KPS score before treatment, the amount of weight loss, body mass index （P 〈 0.05）. The later tumor stage, the lower the KPS score before treatment, the greater the a- mount of weight loss, the lower body mass index, the higher proportion of anemia patients. The overall survival rate （OS） of 1 year, 3 years, 5 years of anemia group and non-anemia group was 78.9%, 51.8%, 30.1%, and 88.9%, 68.8%, 44.1% respectively. The median survival time of non-anemia group was significantly higher than that of anemia group, the difference was statistically significant （X2 = 4. 989, P = 0.026）. Cox regression analysis showed that anemia before radiotherapy was an independent risk factor for the prognosis of patients with esophageal squamous cell carcinoma （ RR = 2. 581, P 〈 0.05 ）. Conclusion： The incidence of anemia in patients with esophageal squamous cell carcinoma before ra- diotherapy was higher, the incidence of anemia and the degree of anemia increased after radiotherapy.

关 键 词：食管鳞癌 放射治疗 贫血 预后 

分 类 号：R735.1[医药卫生—肿瘤] R730.55[医药卫生—临床医学]