229例老年食管鳞癌根治性放疗对比同期放化疗疗效和预后因素分析

发布时间：2018-03-18 08:40

本文选题：食管肿瘤　切入点：放射疗法　出处：《重庆医学》2017年05期 　论文类型：期刊论文

【摘要】：目的分析比较老年食管癌放疗与同期放化疗疗效以及影响预后的因素。方法回顾性分析2009年1月至2013年12月该院接受放疗和同期放化疗的老年食管癌患者229例,用Kaplan-Meier法计算生存率和局控率,比较两组患者近期疗效和远期疗效的差别,并采用COX单因素和多因素分析方法分析影响患者预后的因素。结果全组中位随访时间为15.3个月,单纯放疗组和同期放化疗组CR 35.6%和45.8%,PR 61.0%和53.0%,SD 2.7%和0,PD 0.7%和1.2%,两组近期疗效比较差异无统计学意义(P=0.211);单纯放疗组1、2、3年的局控率分别是82.8%、60.5%、52.7%,而同期放化疗组1、2、3年的局控率89.5%、85.4%、80.9%,两组差异有统计学意义(P=0.009);单纯放疗组1、2、3年生存率分别为66.4%、29.5%、17.1%,同期放化疗组1、2、3年生存率分别为65.9%、40.3%、30.8%,两组生存率差异无统计学意义(P=0.071)。单因素分析显示T、N分期,临床分期以及放疗剂量(60Gy,60~66Gy,66Gy)与患者预后关系密切,COX多因素分析显示,T、N分期和放疗剂量是影响患者预后的独立预后因素。结论在老年食管癌中,同期放化疗可改善局部控制率,但未能显著改善远期生存,T、N分期和放疗剂量是影响老年食管癌预后的独立因素。
[Abstract]:Objective to compare the effects of radiotherapy and chemotherapy on esophageal carcinoma in the elderly and the prognostic factors. Methods from January 2009 to December 2013, 229 patients with esophageal cancer received radiotherapy and concurrent radiotherapy and chemotherapy in our hospital were analyzed retrospectively. The survival rate and local control rate were calculated by Kaplan-Meier method. The difference between the short-term and long-term outcomes was compared between the two groups. The factors affecting the prognosis were analyzed by COX single factor and multivariate analysis. Results the median follow-up time was 15.3 months. Cr 35.6% and PR 61.0% and 53.0 in radiotherapy alone group and radiotherapy and chemotherapy group in the same period showed no significant difference in short-term curative effect between SD 2.7% and PD 0.7% and 1.2, but the local control rate in radiotherapy alone group was 82.8% and 60.552.7% for 2 and 3 years respectively, while the local control rate was 82.8% in chemotherapy group for 3 years. 89.5 + 85.4%, there was significant difference between the two groups (P 0.009); in the radiotherapy alone group, the survival rates for 1 and 3 years were 66.4and 29.5and 17.1respectively, and those for the radiotherapy and chemotherapy group were 65.9and 40.3, respectively. There was no significant difference in survival rate between the two groups (P 0.071). Univariate analysis showed that Ton staging was found in the two groups, and the 3-year survival rate in the chemotherapy and radiotherapy group was 65.9% and 40.3% respectively, and there was no significant difference in the survival rate between the two groups (P < 0.01). The single factor analysis showed that there was no significant difference between the two groups. Clinical stage and radiotherapy dose of 60 Gy / 66 Gy) were closely related to the prognosis of the patients. Cox multivariate analysis showed that the stage of Tnn and the dose of radiotherapy were independent prognostic factors. Conclusion in the elderly patients with esophageal cancer, radiotherapy and chemotherapy can improve the local control rate. However, the long term survival stage and radiotherapy dose were independent factors affecting the prognosis of esophageal cancer in the elderly.
【作者单位】：广东省汕头市中心医院肿瘤放疗科;
【基金】：广东省科技计划项目(2013B021800047)
【分类号】：R735.1

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