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375例食管癌三维适形放疗长期疗效分析
李娟, 祝淑钗, 王玉祥, 刘志坤, 沈文斌, 苏景伟
050011 石家庄,河北医科大学第四医院放疗三科
Analysis the long-term effect of 375 patients with esophageal carcinoma treated by three-dimensional conformal radiotherapy
LI Juan, ZHU Shu-chai, WANG Yu-xiang, LIU Zhi-kun, SHEN Wen-bin, SU Jing-wei
Third Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011,China Corresponding author:ZHU Shu-chai, Email:sczhu@heinfo．net
Abstract：Objective To analyze the outcomes and prognostic factors of advanced esophageal carcinoma treated by three-dimensional conformal radiotherapy (3DCRT). Methods From Jul 200l to Dec 2006. 375 patients with esophageal carcinoma treated by 3DCRT were retrospectively analyzed of which Ⅰstage 9,Ⅱ stage 106, Ⅲ stage 158,Ⅳstage 102． The short-term effect, 1-,3-,5-year local regional control rates and survival rates were investigated．The local regional control rates and survival rate were calculated by the Kaplan-Meier method. Univariate prognostic factor was analyzed by Logrank method．Multivariate prognostic factor was analyzed using Cox regression model. Results The follow-up rate was 94.7%.The numbers of patients followed-up with 5 years was 191.The 1-,3-and 5-year local control rates were 80.5%,53.7%,44.9% respectively．The 1-, 3-and 5-year survival rates were 67.2%,29.4%,19.0% respectively. Univariate analysis showed the significant prognostic factors included the degree of dysphagia, tumor length, the largest diameter of lesion in CT image, T stage, N stage, clinical TNM stage, grades of acute radiation-induced esophagitis and grades of acute radiation-induced pneumonery (χ2=46.75,18.52,30.24,42.53,32.71,75.68,7.13,4.64,P=0.000,0.000,0.000,0.000,0.000,0.000,0.008,0.031)．Multivariate analysis revealed tumor length, clinical TNM stage, chemotherapy and grades of acute radiation-induced esophagitis were independent prognostic factors (χ2=6.70,18.00,4.87,1.18,P=0.030,0.000,0.027,0.011). Conclusions 3DCRT is effective and feasible in treatment of the advanced esophageal carcinoma. Tumor lesion length, clinical TNM stage, chemotherapy and grades of acute radiation-induced esophagitis are independent prognostic factors for survival of patients．
LI Juan,ZHU Shu-chai,WANG Yu-xiang et al. Analysis the long-term effect of 375 patients with esophageal carcinoma treated by three-dimensional conformal radiotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(4): 334-337.
[1] 肖泽芬,章众,张红志,等．用三维治疗计划系统评估食管癌常规放疗中肿瘤剂量的分布．中华放射肿瘤学杂志,2004,13:273-277． [2] 王澜,韩春,祝淑钗,等．食管癌常规照射与三维适形放疗的剂量学研究．中华放射肿瘤学杂志,2006,15:176-l80． [3] 张宜勤,陆进成,翟振宇,等．三维适形放疗食管癌临床研究的初步结果．中华放射肿瘤学杂志,2005,14:3l-34． [4] 蒋杰,王奇峰,肖泽芬,等．132例食管癌三维适形放疗的疗效分析．中华放射肿瘤学杂志,2009,18:47-51． [5] 祝淑钗,李任,李娟,等．非手术治疗胸段食管癌临床分期与预后关系的初步探讨．中华放射肿瘤学杂志,2004,13:189-192． [6] 顾雅佳,王玖华,相加庆,等．CT观察胸段食管癌气管食管沟淋巴结转移的临床意义探讨．中华放射学杂志,2002,36:139-141． [7] Delcambre C, Jacob JH, Dotier D, et al. Localized squamous cell cancer of the esophageal:retrospective analysis of three treatment schedules intensity modulated radiotherapy. Radiother Oncol,2001,59:195-201. [8] 祝淑钗,李任,王玉祥,等．500例中晚期食管癌单纯放疗的多因素分析．中华放射肿瘤学杂志,2005,14:352-358． [9] Stein H, Feith M, Bruecher B, et al. Early esophageal cancer pattern of lymphatic spread and prognostic factors for long-term survival after surgical resection. Ann Surg,2005,242:566-573． [10] 孙克林,张汝刚,张大为,等．食管癌淋巴结转移对手术治疗预后的影响．中华外科杂志,1995,33:222-224． [11] 王玉祥,祝淑钗,苏景伟,等．淋巴结转移对食管癌三维适形放疗疗效的影响．中国肿瘤临床,2011,38:36-41． [12] 王玉祥,祝淑钗,李娟,等．209例食管癌三维适形放疗疗效分析．中华放射肿瘤学杂志,2010,19:101-104． [13] 赵快乐,施学辉,蒋国良．提高食管癌的放射剂量是否有益？—食管癌三维适形放疗临床Ⅰ/Ⅱ期剂量递增实验．中国癌症杂志,2008,18:354-357． [14] 王澜,韩春,张辛,等．食管癌三维适形放疗疗效观察．中华放射肿瘤学杂志,2010,19:101-104． [15] al-Sarraf M, Martz K, Herskovic A, et al. Progress report of combined chemoradiotherapy versus radiotherapy alone in patients with esophageal cancer:an intergroup study. J Clin Oncol,1997,15:277-284． [16] Cooper JS, Guo MD, Herskovic A, et al. Chemoradiotherapy of locally advanced esophageal cancer:long-term follow-up of a prospective randomized trial (RTOG 85- 01).Radiation Therapy Oncology Group. JAMA,1999,281:1623-1627． [17] 宇萌,刘意,李英丽,等．同步放化疗与序贯放化疗治疗食管癌疗效对比观察．山东医药,2009,49:77-78． [18] 刘俊,吕长兴,王家明,等．同步放化疗治疗不能手术的食管癌临床结果．中华放射肿瘤学杂志,2006,15:185-187．
2012, Vol. 21 
