局部复发食管鳞癌再程放化疗后的生存分析和失败模式  

Survival outcomes and patterns of failure of re-irradiation for local recurring esophageal squamous cell carcinoma after primary definitive radiotherapy

作　　者：袁芳芸[1] 侯小明[1] Yuan Fangyun;Hou Xiaoming(Department of Oncology,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院肿瘤科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2023年第1期55-60,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省科技厅临床医学研究中心建设资助项目(21JR7RA390)。

摘　　要：目的 探索根治性放化疗后局部复发食管鳞癌接受再程放化疗患者的生存结果和失败模式。方法 回顾性分析2014年7月-2018年10月接受再程放化疗的局部复发食管鳞癌患者的生存结果、失败模式、不良反应,单因素和多因素分析生存结果。结果 纳入105例食管鳞癌患者,中位无进展生存时间(PFS)和总生存时间(OS)分别为9个月和15个月。多因素分析显示年龄、再程放疗剂量和复发时间是影响患者PFS的独立因素,再程放疗剂量和复发时间是影响患者OS的独立因素。失败模式包括远处转移(41例)、局部区域失败(24例)、原发灶失败(6例)和食管其他部位新发肿瘤(6例)。结论 局部复发食管鳞癌再程放化疗后的失败模式以远处转移为主,再程放疗剂量和年龄是影响患者长期生存的重要因素。Objective To explore the survival and failure modes of local recurrence of esophageal squamous cell carcinoma after primary definitive radiotherapy. Methods Through a retrospective analysis of the survival and failure modes and toxicities of patients with local recurrence esophageal squamous cell carcinoma who received re-irradiation from July 2014 to October 2018, the survivals were analyzed via univariate and multivariate survival analysis. Results A total of 105 cases of esophageal squamous cell carcinoma were included in the study. The median progress free survival(PFS) and overall survival(OS) were 9 and 15months, respectively. Multivariate analysis showed that age, re-irradiation dose and recurrence time were independent factors affecting patients’ PFS, and re-irradiation dose and recurrence time were independent factors affecting patients’ OS. Patterns of failure included distant metastasis, local lymph node failure,primary tumor bed failure and new tumor in other parts of esophagus. Conclusion The most common pattern of failure of local recurrence esophageal squamous cell carcinoma after re-irradiation was distant metastasis.The dose of re-irradiation and age were important factors that affect the survival.

关 键 词：食管鳞状细胞癌 复发 再程放疗 失败模式 

分 类 号：R735.2[医药卫生—肿瘤]