307例Ⅱ-Ⅲ期食管癌同期放化疗预后分析  

Analysis of outcomes and prognostic factors in 307 stages Ⅱ-Ⅲ esophageal cancer patients treated with concurrent chemoradiotherapy

作　　者：程欣宇 吴慧 张瑞瑞[2] 孙学明 闫朱敏 刘晓 陈永顺[3] 

机构地区：[1]郑州大学附属肿瘤医院,450008 [2]南京医科大学附属淮安第一医院病理科,223300 [3]武汉大学人民医院肿瘤中心,430060

出　　处：《中华放射肿瘤学杂志》2018年第2期140-144,共5页Chinese Journal of Radiation Oncology

摘　　要：目的 分析食管癌同期放化疗的疗效和影响因素。方法 2006—2014年间接受3DRT食管癌患者 307例,其中Ⅱ期 73例、Ⅲ期 234例。中位放疗剂量60 Gy,同期化疗方案为PF （166例）、TP （82例）、单药P （59例）。采用Kaplan-Meier法计算OS、PFS率并Logrank法检验和单因素预后分析,Cox模型多因素预后分析。结果 3、5年样本量分别为130、45例,1、3、5年OS和PFS率分别为85.6%、53.8%、36.9%和74.6%、43.7%、33.1%,中位OS、PFS期分别为41.6、29.8个月。单因素分析显示影响OS和PFS因素为T分期、N分期、临床分期、病变部位、病变长度和化疗方案（P=0.007和0.013、0.000和0.000、0.000和0.000、0.002和0.000、0.141和0.005、0.018和0.165）。多因素分析显示T分期、N分期、病变部位、化疗方案是影响OS因素（P=0.024、0.000、0.007、0.028）,病变部位、病变长度、N分期是影响PFS因素（P=0.004、0.033、0.035）。放疗剂量 50-60、〉60-70 Gy的中位OS期和PFS期分别为47.4、37.8个月（P=0.469）和34.1、25.1个月（P=0.233）。结论 Ⅱ—Ⅲ期食管癌同期放化疗可获得较好的生存,联合用药优于单药,低剂量与高剂量放疗疗效相近,不良反应可耐受。Objective To summarize the outcomes and prognostic factors in esophageal cancer （EC） patients. Methods A total of 307 EC patients of stages Ⅱ-Ⅲ were treated with concurrent chemoradiotherapy in our hospital from September 2006 to July 2014.There were 73 patients with stage Ⅱ and 234 with stage Ⅲ.The radiotherapy dose was 50-70 Gy （median 60 Gy）.Concurrent chemoradiotherapy were used with fluorouracil plus platinum （PF,166）,paclitaxel plus platinum （TP,82） or platinum only （P,59）.The Kaplan-Meier method was used to calculate overall survival （OS） and progression-free survival （PFS） rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis. The Cox regression model was used for multivariate prognostic analysis. Results The 1-,3-5-year OS and PFS rates were85.6%,53.8%,36.9% and 74.6%,43.7%,33.1%,respectively. The median OS and PFS were 41.6 months and 29.8 months. The univariate analysis indicated that T stage,N stage,clinical stage,lesion location,lesion length and chemotherapy regimen were prognostic factors for OS and PFS （P=0.007 and 0.013,0.000 and 0.000,0.000 and 0.000,0.002 and 0.000,0.141 and 0.005,0.018 and 0.165）.Multivariate analysis showed that T stage,N stage,lesion location and chemotherapy regimen were prognostic factors for OS （P=0.024,0.000,0.007 and 0.028）,lesion location,lesion length and N stage were prognostic factors for PFS （P=0.004,0.033 and 0.035）.The median OS and PFS for EC patients treated by total dose 50-60 Gy,〉60-70 Gy were 47.4 months,37.8 months（P=0.469） and 34.1 months,25.1 months （P=0.0.233）,there were no statistic difference. Conclusions The outcome of EC patients treated with concurrent chemoratherapy could obtain a long-term survival,combination chemotherapy is superior to single drug,there are no statistical difference between high-dose and low-dose,and the acute toxic effects can be tolerated.

关 键 词：食管肿瘤/放射疗法 食管肿瘤/化学疗法 预后 

分 类 号：R735.1[医药卫生—肿瘤]