307例Ⅱ—Ⅲ期食管癌同期放化疗预后分析

doi:10.3760/cma.j.issn.1004-4221.2018.02.004

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摘要目的分析食管癌同期放化疗的疗效和影响因素。方法 2006—2014年间接受3DRT食管癌患者 307例,其中Ⅱ期 73例、Ⅲ期 234例。中位放疗剂量60 Gy,同期化疗方案为PF (166例)、TP (82例)、单药P (59例)。采用Kaplan-Meier法计算OS、PFS率并Logrank法检验和单因素预后分析,Cox模型多因素预后分析。结果 3、5年样本量分别为130、45例,1、3、5年OS和PFS率分别为85.6%、53.8%、36.9%和74.6%、43.7%、33.1%,中位OS、PFS期分别为41.6、29.8个月。单因素分析显示影响OS和PFS因素为T分期、N分期、临床分期、病变部位、病变长度和化疗方案(P=0.007和0.013、0.000和0.000、0.000和0.000、0.002和0.000、0.141和0.005、0.018和0.165)。多因素分析显示T分期、N分期、病变部位、化疗方案是影响OS因素(P=0.024、0.000、0.007、0.028),病变部位、病变长度、N分期是影响PFS因素(P=0.004、0.033、0.035)。放疗剂量 50~60、>60~70 Gy的中位OS期和PFS期分别为47.4、37.8个月(P=0.469)和34.1、25.1个月(P=0.233)。结论 Ⅱ—Ⅲ期食管癌同期放化疗可获得较好的生存,联合用药优于单药,低剂量与高剂量放疗疗效相近,不良反应可耐受。

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	程欣宇
	吴慧
	张瑞瑞
	孙学明
	闫朱敏
	刘晓
	陈永顺

关键词 ：食管肿瘤/放射疗法, 食管肿瘤/化学疗法, 预后

Abstract：Objective To summarize the outcomes and prognostic factors in esophageal cancer (EC) patients. Methods A total of 307 EC patients of stages Ⅱ-Ⅲ were treated with concurrent chemoradiotherapy in our hospital from September 2006 to July 2014.There were 73 patients with stage Ⅱ and 234 with stage Ⅲ.The radiotherapy dose was 50-70 Gy (median 60 Gy).Concurrent chemoradiotherapy were used with fluorouracil plus platinum (PF,166),paclitaxel plus platinum (TP,82) or platinum only (P,59).The Kaplan-Meier method was used to calculate overall survival (OS) and progression-free survival (PFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis. The Cox regression model was used for multivariate prognostic analysis. Results The 1-,3-5-year OS and PFS rates were85.6%,53.8%,36.9% and 74.6%,43.7%,33.1%,respectively. The median OS and PFS were 41.6 months and 29.8 months. The univariate analysis indicated that T stage,N stage,clinical stage,lesion location,lesion length and chemotherapy regimen were prognostic factors for OS and PFS (P=0.007 and 0.013,0.000 and 0.000,0.000 and 0.000,0.002 and 0.000,0.141 and 0.005,0.018 and 0.165).Multivariate analysis showed that T stage,N stage,lesion location and chemotherapy regimen were prognostic factors for OS (P=0.024,0.000,0.007 and 0.028),lesion location,lesion length and N stage were prognostic factors for PFS (P=0.004,0.033 and 0.035).The median OS and PFS for EC patients treated by total dose 50-60 Gy,>60-70 Gy were 47.4 months,37.8 months(P=0.469) and 34.1 months,25.1 months (P=0.0.233),there were no statistic difference. Conclusions The outcome of EC patients treated with concurrent chemoratherapy could obtain a long-term survival,combination chemotherapy is superior to single drug,there are no statistical difference between high-dose and low-dose,and the acute toxic effects can be tolerated.

Key words： Esophageal neoplasms/radiotherapy Esophageal neoplasms/chemotherapy Prognosis

收稿日期: 2017-08-25

通讯作者: 吴慧,Email:wuhui7008@126.com

引用本文:

程欣宇,吴慧,张瑞瑞等. 307例Ⅱ—Ⅲ期食管癌同期放化疗预后分析[J]. 中华放射肿瘤学杂志, 2018, 27(2): 140-144.

Cheng Xinyu,Wu Hui,Zhang Ruirui et al. Analysis of outcomes and prognostic factors in 307 stages Ⅱ-Ⅲ esophageal cancer patients treated with concurrent chemoradiotherapy[J]. Chinese Journal of Radiation Oncology, 2018, 27(2): 140-144.

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