格拉斯哥评分对局部晚期食管癌放化疗预后判断的价值探讨  

Prognostic Value of the GPS for Locally Advanced Esophageal Cancer after Chemo-radiotherapy

作　　者：林贵山[1] 骆华春[2] LIN Guishan;LUO Huachun(Department of Medical Oncology,Fujian Province Hospital,Provincial Clinic College of Fujian Medical University,Fuzhou 350001,China;Department of Radiation Oncology,Fuzhou General Hospital of PLA,Fuzhou 350025,China)

机构地区：[1]福建医科大学省立临床学院,福建省立医院肿瘤内科,福州350001 [2]福建医科大学福州总院临床学院,南京军区福州总医院放疗科,福州350025

出　　处：《福建医科大学学报》2019年第4期252-256,共5页Journal of Fujian Medical University

基　　金：福建省卫计委医学创新课题(2018-CX-3)

摘　　要：目的探讨治疗前后格拉斯哥评分(GPS)以及GPS变化对局部晚期食管癌同步放化疗预后判断的价值。方法收集接受同步放化疗的局部晚期食管癌患者117例,分析患者的临床特征及治疗前后的GPS,根据治疗后GPS的变化情况将患者分为好转组、无变化组和恶化组,分析3组间的局部无复发率和总生存率差异。采用Cox风险模型分析影响局部无复发率(RFS)和总生存率(OS)的预后因素。结果治疗后GPS有变化者51例(43.59%),其中好转者21例(17.95%)、恶化者30例(25.64%)。治疗后好转组、无变化组和恶化组之间的局部RFS和OS差别均有统计学意义。多因素分析显示,治疗前GPS、治疗后GPS和TNM分期是RFS和OS的独立预测因素。结论GPS是个简便、有效的肿瘤炎症指标,在临床上可用于预测实体肿瘤的疗效,动态观察治疗前后的GPS可更好地预测局部晚期食管癌放化疗的疗效。Objective To analyze the prognostic value of the Glasgow Prognostic Score(GPS)of pretreatment,posttreatment,and change thereof for patients with locally advanced esophageal cancer after chemoradiotherapy.Methods 117 patients with locally advanced esophageal cancer who were eligible for chemoradiotherapy were enrolled and their clinical characteristics and the GPS of pretreatment,posttreatment and change thereof were collected.The patients were divided into three groups according to the change inGPS after treatment(improved,stable,and worse group).Recurrence free survival(RFS)and overall survival(OS)pretreatment,posttreatment,and change thereof were analyzed using a KaplanMeier survival curve analysis,and a logrank test was applied to determine the statistical differences in survival outcomes.Multivariate analysis was performed to screen for potential variables affecting RFS and OS based on Cox proportionalhazards models.Results After treatment,the GPS changed in 51(43.59%)patients,with improved GPS in 21(17.95%)patients,and worse GPS in 30(25.62%).At the end of followup,there were significant differences in the RFS and OS according to the pretreatment GPS(P=0.042,P=0.039)and posttreatment GPS(P=0.016,P=0.015).There were significant differences in the RFS and OS(P<0.000,P=0.001)between three groups according to the different changes in GPS after treatment respectively.Multivariate analysis demonstrated that pretreatment GPS(P=0.025,0.027),posttreatment GPS(P=0.011,0.014),and cancer TNM staging(P=0.031,0.043)were associated with RFS and OS.Conclusion GPS is a simple and effective index of systemic inflammatory response for analyzing the value of prognosis for solid tumor in the clinic.The dynamics of GPS has better value for analyzing the prognosis of patients with locally advanced esophageal cancer after chemoradiotherapy.

关 键 词：食管肿瘤 格拉斯哥预后评分 预后 

分 类 号：R735.1[医药卫生—肿瘤]