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根治性放疗获临床完全缓解食管鳞癌患者10年生存分析
李润霄, 沈文斌, 曹彦坤, 宋春洋
河北医科大学第四医院放疗科,石家庄 050011
Analysis of the 10-year survival results of patients with esophageal squamous cell carcinoma achieving clinical complete remission after radical radiotherapy
Li Runxiao, Shen Wenbin, Cao Yankun, Song Chunyang
Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Abstract：Objective To investigate the long-term prognosis and failure mode of patients with esophageal squamous cell carcinoma who achieved clinical complete remission (cCR) after receiving radical radio (chemo) therapy. Methods Clinical data of 183 patients with esophageal squamous cell carcinoma eligible for inclusion criteria who received treatment in our hospital from January 2009 to December 2012 were retrospectively analyzed. The factors that affected the long-term prognosis of patients were identified, and the failure mode of cCR patients and the prognosis after failure were analyzed. SPSS 19.0statistical software was used for data analysis. Results As of the follow-up date, the 1-, 3-, 5-, and 10-year overall survival (OS) rates and disease-free survival (DFS) rates of the entire group were 83.1%,53.4%,36.2%,12.8% and 68.9%,45.9%, 30.5%, 12.0%,respectively. The median OS and DFS were 41.3 months and 33.4 months. The results of multivariate analysis showed that cT staging, cN staging and prescribed dose were the independent factors affecting the OS (P=0.001, <0.001, 0.003);hoarseness, lesion length, cT staging, cN staging and prescribed dose were the independent factors that affected the DFS (P=0.002, 0.033, 0.009,<0.001, 0.003). In the whole group,72 cases (39.3%) had local regional recurrence,58 cases (31.7%) had distant metastasis, and 26 cases (14.2%) had local regional recurrence with distant metastasis. Among 104 patients after treatment failure, the prognosis of patients receiving salvage treatment was significantly better than that of their counterparts receiving maintenance treatment (χ2=39.153, P<0.001). Conclusions The long-term prognosis of patients with esophageal squamous cell carcinoma who achieved cCR after receiving radical radio (chemo) therapy is still unsatisfactory. Clinically, it is necessary to strengthen the clinical observation and follow-up of these patients. The main treatment failure mode of cCR patients is local regional recurrence. Active salvage treatment can significantly improve clinical prognosis of these patients.
Li Runxiao,Shen Wenbin,Cao Yankun et al. Analysis of the 10-year survival results of patients with esophageal squamous cell carcinoma achieving clinical complete remission after radical radiotherapy[J]. Chinese Journal of Radiation Oncology, 2022, 31(6): 525-531.
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