食管癌新辅助放化疗患者发生放射性食管炎的现状调查和相关因素分析  

Investigating of radiation esophagitis in esophageal cancer patients for neoadjuvant chemoradiotherapy and analysis of related factors

作　　者：端木知良 祁冉[1] DUANMU Zhi-liang;QI Ran(Department of Gastroenterology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院消化内科,河南洛阳471000

出　　处：《医药论坛杂志》2025年第3期289-292,共4页Journal of Medical Forum

摘　　要：目的调查分析食管癌患者在接受新辅助放化疗期间放射性食管炎的发病率、相关影响因素,并提出干预策略。方法对河南科技大学第一附属医院2020年8月至2023年6月178名接受新辅助放化疗的食管癌患者医疗记录回顾评估,按放射治疗肿瘤研究组(radiation therapy oncology group,RTOG)的标准分为发生组(65例,RTOG≥2级)和未发生组(113例,RTOG<2级),多因素logistic回归分析放射性食管炎独立危险因素,受试者工作特征(ROC)曲线分析预测效能并提出干预策略。结果放射性食管炎分级中0级、1级、2级、3级患者占比分别为42.70%、20.79%、32.58%、19.66%。确诊放射性食管炎患者占比36.51%。Logistic回归分析结果显示,伴随基础疾病、病理阶段和平均照射剂量是发生放射性食管炎的独立影响因素(P<0.05);上述因素的ROC曲线下面积(AUC)分别为0.634、0.596、0.646。针对上述因素,干预措施包括严格控制基础疾病、选择适宜的放疗技术和剂量、优化药物方案、加强营养支持和症状监测等。结论新辅助放化疗的食管癌患者易患放射性食管炎,主要由基础疾病、晚期病理和高照射剂量引起。识别上述因素有助于早期预警和临床预防,需针对性采取措施以提高效果。Objective To investigate and analyze the incidence rate of radiation-induced esophagitis in esophageal cancer patients undergoing neoadjuvant chemoradiotherapy,as well as relevant influencing factors,and propose intervention strategies.Methods A retrospective evaluation of the medical records of 178 esophageal cancer patients who received neoadjuvant chemoradiotherapy at the First Affiliated Hospital of Henan University of Science and Technology from August 2020 to June 2023.They were divided into occurrence group(65 cases,RTOG≥2)and non-occurrence group(113 cases,RTOG<2).Multivariate logistic regression was used to analyze independent risk factors for radiation esophagitis.ROC curve was used to analyze predictive efficacy and propose intervention strategies.Results The proportions of patients with grades 0,1,2,and 3 of radiation esophagitis were 42.70%,20.79%,32.58%,and 19.66%respectively.The proportion of diagnosed radiation esophagitis patients was 36.51%.Logistic regression analysis showed that concomitant underlying diseases,pathological stage,and average radiation dose were independent influencing factors for radiation esophagitis(P<0.05).The AUCs of the above factors were 0.634,0.596,and 0.646 respectively.Intervention measures include strictly controlling underlying diseases,choosing appropriate radiotherapy techniques and doses,optimizing drug regimens,strengthening nutritional support and symptom monitoring.Conclusion Esophageal cancer patients receiving neoadjuvant chemoradiotherapy are prone to radiation esophagitis,mainly caused by underlying diseases,advanced pathology,and high radiation doses.Identifying these factors is helpful for early warning and clinical prevention.Targeted measures should be taken to improve the effect.

关 键 词：食管癌 早期症状群调查 相关因素分析 干预策略 

分 类 号：R735[医药卫生—肿瘤]