非区域淋巴结转移与胸段局部晚期食管鳞癌同步放化疗预后的关系  

The prognostic value of non-regional lymph node metastasis in patients with locally advanced thoracic esophageal squamous cell carcinoma receiving curative concurrent chemoradiotherapy

作　　者：管云峰 张海兵[1] GUAN Yunfeng;ZHANG Haibin(Department of Radiation Oncology,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]湖州市中心医院放疗科,313000

出　　处：《浙江医学》2021年第19期2073-2077,共5页Zhejiang Medical Journal

基　　金：浙江省医学会临床科研基金项目(2020ZYC-A32)。

摘　　要：目的探究非区域淋巴结转移与胸段局部晚期食管鳞癌根治性同步放化疗预后的关系。方法回顾性分析2013年1月至2018年12月湖州市中心医院接受根治性同步放化疗的139例胸段食管癌患者的病历及随访资料,其中有非区域淋巴结转移患者33例为观察组,无非区域淋巴结转移患者106例为对照组,采用倾向性评分匹配法1∶1匹配,分析比较两组患者同步放化疗后的总缓解率、无进展生存期(PFS)及总生存期(OS)。结果观察组总缓解率为57.5%;对照组总缓解率为76.4%(P<0.05);倾向性评分匹配前,观察组和对照组中位PFS分别为7.3个月和13.0个月,中位OS分别为12.1个月和19.6个月。观察组PFS和OS均短于对照组(均P<0.05)。匹配后,观察组和对照组中位PFS分别为7.3个月和12.4个月,中位OS分别为12.1个月和19.8个月,观察组PFS和OS仍短于对照组(均P<0.05)。非区域淋巴结转移、cTNM是影响PFS和OS的独立危险因素。结论非区域淋巴结转移是影响接受根治性同步放化疗胸段局部晚期食管鳞癌患者预后的重要因素。Objective To analyze the prognostic value of non-regional lymph node metastasis in patients with locally advanced thoracic esophageal squamous cell carcinoma receiving curative concurrent chemoradiotherapy.Methods The medical records and follow-up data of 139 patients with thoracic esophageal carcinoma receiving concurrent chemoradiotherapy in our hospital fromJanuary 2013 to December 2018 were retrospectively analyzed,including 33 patients with non-regional lymph node metastasis(study group)and 106 patients without non-regional lymph node metastasis(control group).The propensity score matching(PSM)method was used to match patients with non-regional lymph node metastasis and patients without non-regional lymph node metastasis.The overall response(OR)rate,progression-free survival(PFS)and overall survival(OS)were compared between the two groups.Results The OR rate in the study group and the control group was 57.5%and 76.4%(P<0.05).The median PFS time in the study group and the control group was 7.3 months and 13.0 months,and the median OS time was 12.1 months and 19.6 months(P<0.05).After PSM,The median(PFS)time in the study group and the control group was 7.3 months and 12.4 months,and the median OS time was 12.1 months and 19.8 months,respectively(P<0.05).Non-regional lymph node metastasis and cTNM were independent risk factors of PFS and OS in patients with locally advanced thoracic esophageal squamous cell carcinoma.Conclusion Esophageal squamous cell carcinoma patients with non-regional lymph node metastasis have a worse prognosis.

关 键 词：食管鳞癌 同步放化疗 非区域淋巴结转移 预后 

分 类 号：R735.1[医药卫生—肿瘤]