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非手术治疗食管癌临床分期标准的临床应用与探讨
王澜, 孔洁, 韩春, 高超, 张靖, 李晓宁, 田华
050011 石家庄,河北医科大学第四医院放疗科
The evaluation of prognosis and investigation of clinical staging for esophageal carcinoma treated with non-surgical methods
WANG Lan, KONG Jie, HAN Chun, GAO Chao, ZHANG Jing, LI Xiao-ning, TIAN Hua
Department of Radiation Oncology,Fourth Hospital of Hebei Medical University, Shijiazhung 050011, China Corresponding author:HAN Chun, Email:hanchun2006@126.com
Abstract：Objective To analyze the prognosis of 784 patients according with clinical staging of esophageal carcinoma treated with non-surgical methods, investigate the predictive value and deficiency of the clinical staging. Methods From July 2003 to January 2009, 784 patients with esophageal carcinoma received 3DCRT treatment. The prescribed doses ranged from 50 Gy-70 Gy with median dose of 60 Gy, 1.8－2.0 Gy/fraction, 1 fraction/day, 5 fractions/week. 65 patients received prescription dose of<60 Gy and all the others′≥60 Gy. All the patients were divided into subgroups according to different T, N and TNM stages. Therapeutic effect was evaluated. Results The follow up rate was 97.1%, 503 patients were followed up for more than 3 years and 122 were followed up for more than 5 years. The 1-,3-,5-year local control rates and overall survival rates were 77.2%,54.2%, 46.5% and 69.5%,34.9%, 23.9%, respectively, with median survival time of 21 months. There were significant differences of survival curves for different T stages, N stages and TNM stages. For the groups of stageⅠ,Ⅱ and Ⅲ, the 1-,3-,5-year survival rates were 86.4%, 47.6%, 45.1%;84.7%, 46.3%, 36.4% and 64.0%, 30.9%, 19.1%,respectively (χ2=29.34,P=0.000). There were 752 patients with squamous cell carcinoma (95.9%) and 32 patients with non-squamous cell carcinoma (4.1%), the median survival time were 21 and 16 months, respectively (χ2=4.44,P=0.035). There were significant difference of survival rates for the subgroups whose GTV volume ≤20 cm3, 20－40 cm3, 40－60 cm3 and>60 cm3(54 months,29 months,21 months and 14months,χ2=68.71,P=0.000). Conclusions The clinical staging of esophageal carcinoma treated with non-surgical methods could predict the prognosis accurately, for patients with different pathology and GTV volumes, there were variance in the prognosis, so we advised the complement of the two factors in the draft of clinical stages.
WANG Lan,KONG Jie,HAN Chun et al. The evaluation of prognosis and investigation of clinical staging for esophageal carcinoma treated with non-surgical methods[J]. Chinese Journal of Radiation Oncology, 2012, 21(4): 330-333.
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2012, Vol. 21 
