胸中下段食管癌放疗±化疗后心源性死亡的初步分析

doi:10.3760/cma.j.issn.1004-4221.2016.01.009

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Abstract Objective To analyze the influencing factors for cardiac death (CD) after radical radiotherapy with or without chemotherapy in patients with middle-or lower-thoracic esophageal cancer. Methods The clinical data of 140 patients who met the inclusion criteria were analyzed retrospectively, as well as the effect of cardiac dose-volume factors suggested by dose-volume histogram in the therapeutic regimen on CD. Chi-square test was applied for comparison of categorical data between groups, and independent-samples t-test was applied for comparison of continuous data between groups;logistic regression analysis was applied to analyze the association of cardiac dose-volume and clinical factors with CD. Results
A total of 103 patients died, including 8 patients with CD (7.8%). The univariate analysis of CD showed that age ≥70 years (P=0.033), a history of diabetes (P=0.043), lower-thoracic esophageal cancer (P=0.017), and the length of esophageal lesions>5 cm on esophagography (P=0.013) were risk factors for CD, and heart D_mean(P=0.032) and heart V₅₀(P=0.045) were influencing factors. The results of ROC curve analysis showed that heart D_mean could effectively predict CD (P=0.044), with a cut-off value of 3325 cGy. The results of multivariate logistic analysis showed that the length of esophageal lesions on esophagography (P=0.013) and heart D_mean(P=0.034) were independent prognostic factors for CD. Conclusions The length of esophageal lesions on esophagography and heart D_mean were independent prognostic factors for CD, and the value of heart D_mean can effectively predict CD;therefore, it is suggested that the value of heart D_mean be controlled during the development of therapeutic regimens.

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	Articles by authors
	Shen Wenbin
	Gao Hongmei
	Zhu Shuchai
	Li Youmei
	Cao Yankun
	Liu Zhikun
	Li Shuguang
	Su Jingwei
	Li Juan

Key words： Esophageal neoplasms/radiotherapy Esophageal neoplasms/chemotherapy Cardiac death

Received: 21 October 2014

Corresponding Authors: Zhu Shuchai,Email:wbshen1979@sohu.com

Cite this article:

Shen Wenbin,Gao Hongmei,Zhu Shuchai et al. Analysis of influencing factors for cardiac death after radiotherapy with or without chemotherapy for middle-or lower-thoracic esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(1): 32-36.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.01.009 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I1/32

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