1 637例食管癌调强放射治疗的疗效和预后因素分析  

Analysis of the efficacy and prognostic factors of 1637 esophageal cancer patients treated with intensity-modulated radiotherapy

作　　者：李晨 谭立君[2] 刘晓[3] 韩炜明 高麟芮 王诗嘉 周宗玫 冯勤付 陈东福 梁军[4] 吕纪马 王文卿 惠周光 王绿化[4] 王鑫 刘文扬 邓垒 王健仰 翟医蕊 张涛 毕楠 肖泽芬 Li Chen;Tan Lijun;Liu Xiao;Han Weiming;Gao linrui;Wang Shijia;Zhou Zongmei;Feng Qinfu;Chen Dongfu;Liang Jun;Lyu Jima;Wang Wenqing;Hui Zhouguang;Wang Lyuhua;Wang Xin;Liu Wenyang;Deng Lei;Wang Jianyang;Zhai Yirui;Zhang Tao;Bi Nan;Xiao Zefen(Department of Radiation Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking,First Affiliated Hospital of Harbin Medical College,Harbin 150000,China;Department of Radiation Oncology,Henan Cancer Hospitaly Zhengzhou 450000,China;Department of Radiation Oncology,Cancer Hospitaly Chinese Academy of Medical Sciences,Shenzhen Center,Shenzhen 518000,China;Department of VIP,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院放疗科,100021 [2]哈尔滨医科大学附属第一医院肿瘤一科,150000 [3]河南省肿瘤医院放疗科,郑州450000 [4]中国医学科学院肿瘤医院深圳医院放疗科,518000 [5]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院特需医疗部,100021

出　　处：《中华肿瘤杂志》2021年第6期678-684,共7页Chinese Journal of Oncology

基　　金：国家重大研发计划(2016YFC0904600)。

摘　　要：目的分析调强放射治疗对食管癌患者预后的影响。方法回顾性分析2005年1月至2017年12月中国医学科学院肿瘤医院收治的1 637例食管癌患者的临床和随访资料,分析全组患者的5年总生存率、5年无进展生存率以及复发模式,预后影响因素分析采用Log rank检验和Cox多因素回归分析。结果全组患者的1、3、5年总生存率分别为65.9%、34.2%和27.0%,1、3、5年无进展生存率分别为45.8%、25.0%和18.5%。中位总生存时间为19.4个月(95%CI为18.0~20.7个月),中位无进展生存时间为10.4个月(95%CI为9.3~11.3个月)。单因素分析结果显示,性别、卡氏体力状态评分(KPS)、肿瘤部位、T分期、N分期、M分期、TNM分期、放疗剂量和治疗模式与食管癌患者的5年总生存率和5年无进展生存率均有关(均P<0.05)。多因素分析结果显示,性别、KPS、TNM分期、放疗剂量和治疗模式是影响患者5年总生存率和5年无进展生存率的独立预后因素(均P<0.05)。结论食管癌患者接受调强放射治疗后,其生存率有明显提高。性别、KPS、TNM分期、放疗剂量和治疗模式是影响食管癌患者预后的独立因素。Objective To summarize survival outcomes and prognostic factors in esophageal cancer(EC)patients treated with intensity-modulated radiotherapy(IMRT).Methods A retrospective analysis was performed on the clinical and follow-up data of 1637 patients with EC who were admitted to our hospital from January 2005 to December 2017 and met the inclusion criteria.The 5-year overall survival(OS),progression-free survival(PFS)and pattern of recurrence were analyzed.The Kaplan-Meier method was used to calculate survival rates,Log-rank test for univariate analysis and Cox method for multivariate analysis were used to detect survival difference.Results 1-year,3-year and 5-year OS and PFS of the entire group were 65.9%and 45.8%,34.2%and 25.0%,27.0%and 18.5%,respectively.Median OS and PFS were 19.4 months(95% Cl=18.0-20.7 months)and 10.4 months(95% CI=9.3-11.3 months),respectively.Univariate analysis showed that the sex,KPS,tumor location,T stage,N stage,M stage,TNM stage,radiation dose and treatment modality were prognostic factors for 5-year OS and PFS of EC patients(P<0.05).Multivariate analysis indicated that the sex,KPS,TNM stage,radiation dose and treatment modality were independent prognostic factors for 5-year OS and PFS(P<0.05).Conclusions EC patients treated with IMRT can obtain a promising survival.The sex,KPS,TNM stage,radiation dose and treatment modality are independent prognostic factors for prognosis.

关 键 词：食管肿瘤 调强放射治疗 治疗模式 预后 

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