增加肿瘤区单次剂量对接受根治性放疗的食管鳞癌患者的预后影响  

Effect of Increase of the Single Radiation Dose on the Prognosis of Patients with Esophageal Squamous Cell Carcinoma Receiving Radical Radiotherapy

作　　者：吴佳 李轩 黄建锋 周嘉梁[1] WU Jia;LI Xuan;HUANG Jian-feng;ZHOU Jia-liang(Department of Radiotherapy,Affiliated Hospital of Jiangnan University,Wuxi,Jiangsu,214122,China;Department of Radiotherapy,Huishan People's Hospital,Wuxi,Jiangsu,214187,China)

机构地区：[1]江南大学附属医院肿瘤放疗科,江苏无锡214122 [2]无锡市惠山区人民医院肿瘤科,江苏无锡214187

出　　处：《中国血液流变学杂志》2022年第2期257-261,共5页Chinese Journal of Hemorheology

基　　金：江南大学附属医院临床研究与转化医学研究项目(LCYJ202211)。

摘　　要：目的研究增加肿瘤区单次剂量对接受根治性放疗的食管鳞癌患者的预后影响。方法回顾性分析2014年09月—2019年07月在江南大学附属医院接受根治性放疗的食管鳞癌患者88例,依据给予肿瘤区的单次剂量不同将患者分为单次剂量≤2 Gy组(n=48)和单次剂量>2 Gy组(n=40),比较两组患者的1年生存率、3年生存率、中位生存期(OS)和中位无进展生存期(PFS),并采用Cox比例风险模型分析食管癌患者预后的影响因素。结果单次剂量>2 Gy组和≤2 Gy组中位OS均为25个月,中位PFS分别为15个月和12个月,1年OS率、3年OS率分别为87.5%和81.3%、40%和22.9%,前者相比后者生存率有改善趋势,但两者差异均无统计学意义(P>0.05)。两组患者血液毒性、放射性食管炎、放射性肺损伤的发生率差异均无统计学意义(P>0.05)。多因素分析显示病变长度、TNM分期、放射性食管炎程度、放射性肺损伤程度是不可手术食管癌患者的预后的独立影响因素。结论对于接受根治性放疗的食管癌患者,增加PTV单次剂量具有可行性和安全性。Objective To investigate the effect of increase of the single radiation dose on the prognosis of patients with esophageal squamous cell carcinoma receiving radical radiotherapy.Methods Clinical data of 88 patients with esophageal squamous cell carcinoma in Affiliated Hospital of Jiangnan University from September 2014 to July 2019 were retrospectively reviewed.According to the difference of single dose of PTV,patients were divided into single dose≤2 Gy group(n=48)and single dose>2 Gy group(n=40).1-year survival rate,3-year survival rate,median survival time were compared between the two groups.Results The median OS were 25 months in single dose≤2 Gy group and single dose>2 Gy group.The progression-free survival were 15 months and 12 months.The 1,3-year overall survival rate was 87.5%,40%and 81.3%,22.9%.There was no significant difference in acute side effects of blood toxicity,radiation esophagitis and radiation-induced lung injury between the two groups(all P>0.05).Multivariate analysis showed that lesion length,TNM stage,the degrees of radiation esophagitis and radiation-induced lung injury were independent prognostic factors.Conclusion The increase of the single radiation dose may be a way to improve the survival of esophageal squamous cell carcinoma patients receiving radical radiotherapy and may not increase the side effects.

关 键 词：食管肿瘤/食管癌 鳞状细胞癌 根治性放疗 单次剂量 预后 

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