术后化疗对术后淋巴结阳性胸段食管鳞癌患者预后的影响  

Effect of Postoperative Chemotherapy on Prognosis of Postoperative Lymph Nodepositive Thoracic Esophageal Squamous Cell Carcinoma Patients

作　　者：沈文斌[1] 高红梅[2] 祝淑钗[1] 李幼梅[1] 李腾[1] 李曙光[1] 许金蕊 刘志坤[1] 李娟[1] 苏景伟[1] SHEN Wenbin;GAO Hongmei;ZHU Shuchail;LI Youmei;LI Teng;LI Shuguang;XU Jinrui;LIU Zhikun;LI Juan;SU Jingwei(Department of Radiation Oncology,The Fourth Hospital,Hebei Medical University,Shij＇iazhuang 050011,China;Department of Radiation,The First Hospital of Shijiazhuang,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院放疗科,石家庄050011 [2]石家庄市第一医院影像科,石家庄050011

出　　处：《肿瘤防治研究》2018年第10期762-767,共6页Cancer Research on Prevention and Treatment

摘　　要：目的分析术后化疗对术后淋巴结阳性胸段食管鳞癌患者预后的影响。方法回顾性分析419例胸段食管癌患者预后的影响因素。结果单纯手术患者1、3、5年OS显著低于术后化疗组(χ~2=12.802, P=0.000);而两组患者1、3、5年DFS差异未见统计学意义(χ~2=1.159, P=0.282)。多因素分析结果显示,性别、年龄、病变部位、TNM分期、术后化疗和化疗周期数为OS的独立性预后影响因素(P<0.05);而性别和N分期为DFS的独立性预后影响因素(P<0.05)。分层分析结果显示,相对于单纯手术,术后化疗可以提高男性、年龄≤60岁、胸中下段病变、病变长度≤5.0 cm和ⅢB期患者的OS(P<0.05),而且可以提高男性和年龄≤60岁患者的DFS(P<0.05)。结论术后淋巴结阳性胸段食管鳞癌患者预后较差,术后化疗可以提高部分患者的预后。Objective To analyze the effect of postoperative chemotherapy（POCT） on the prognosis of postoperative lymph node-positive thoracic esophageal squamous cell carcinoma（TESCC） patients. Methods We retrospectively analyzed the prognostic factors for 419 lymph node-positive TESCC patients. Results Compared with POCT group, the 1-, 3-and 5-year OS was significantly lower in patients with surgery alone（χ2=12.802, P=0.000）, while there was no significant difference in 1-, 3-or 5-year DFS（χ2=1.159, P=0.282）. Multivariate analysis results showed that gender, age, location of lesion, TNM stage, POCT and chemotherapy cycles were the prognostic factors of OS（P〈0.05）, and gender and N stage were the independent prognostic factors of DFS（P〈0.05）. Hierarchical analysis results showed that POCT increased OS of male patients ≤60 years of age, lower thoracic lesions, lesions ≤5.0 cm and stage ⅢB, compared with surgery alone（P〈0.05）, and also increased DFS of men ≤60 years of age（P〈0.05）. Conclusion The prognosis of postoperative lymph node-positive TESCC patients is poor, POCT could improve the prognosis of some patients.

关 键 词：食管鳞癌 手术治疗 辅助化疗 预后 

分 类 号：R735.1[医药卫生—肿瘤]