摘要
目的比较食管癌患者单纯放疗与同期放化疗的预后。方法回顾分析2005年6月至2007年6月的266例食管癌患者的临床资料，单纯放疗128例，同期放化疗138例，普通放疗157例，调强放疗109例，Kaplan．Meier法计算生存率，Log—rank法对各临床因素进行单因素分析，Cox回归模型进行多因素分析。两组临床资料和不良反应比较用xz检验。结果单纯放疗组的中位生存时间为25个月，同期放化疗组的中位生存时间为28个月。随访满1、3、5年者分别是231、106、82例。其1、3、4年总生存（OS）率分别为86．8％（200／231），12．8％（14／106）、9．0％（7／82）；无瘤生存（DFS）率分别为39．8％（92／231）、7．9％（8／106）、15．8％（13／82）；无局部区域复发生存（LRFS）率分别为30．8％（71／231）、162％（17／106）、23．7％（19／82）；无远处转移生存（DMFS）率分别为47．0％（109／231）、11-3％（12／106）、13．9％（11／82）。单因素分析结果显示年龄、病变长度、x线分型、不同的放疗方法是5年OS率的独立预后因素，其中年龄、病变长度是DFS率的独立预后因素，病变长度、不同的放疗方法是LRFS率的独立预后因素，病变长度、x线分型是DMFS率的独立预后因素。多因素分析结果显示年龄、病变长度、病理类型是5年OS率的相关因素，而年龄、病变长度、不同的治疗方法是OS率的相关因素，仅病变长度是LRFS率的相关因素，病变长度、不同的化疗方法是DMFS率的相关因素。同期放化疗组的严重不良反应高于单纯放疗组，差异有统计学意义。结论同期放化疗可提高DFS率，同时不良反应的发生率也增高，但5年OS率无明显提高。
Objective To compare prognosis of esophageal cancer patients with simple radiation or chemoradiotherapy. Methods Retrospective analysis 266 cases of esophageal cancer patients from June 2005 to June 2007 of, including 128 with simple radiotherapy, 138 with chemotherapy during the same period, 157 cases of general radiotherapy, intensity-modulated radiotherapy, 109 cases of Kaplan-Meier method for calculation of survival, Log-Rank method on the clinical factors of single factor analysis, Cox regression model with factor analysis. Two groups, clinical material and adverse reaction were compared with chi-square test. Results The median survival time of the radiation group was 25 months, ehemoradiotherapy group of the median survival time was 28 months. Follow-up with 1, 3, 5 years were 231, 106, 82 cases. The 1, 3, 4 years OS rate were 86.8 % （200/231）, 12.8 % （14/106）, 9.0 % （7/82）. Disease-free survival （DFS） rates were 39.8 % （92/231）, 7.9 % （81106）, 15.8 % （13182）. No local relapse survival （LRFS） rates were 30.8 % （711231）, 16.2 % （17/106）, 23.7 % （19/82）. No distant metastasis （DMFS） survival rates were 47.0 % （109/231）, 11.3 go （12/106）, 13.9 % （11/82）. Single factor analysis results show that age, disease length, X-ray parting, different radiation method were 5 years OS independent prognostic factors. Age, disease length were DFS independent prognostic factors. Lesion length, different radiation method were LRFS independent prognostic factors for survival, lesion length and X-ray parting were without distant metastases independent prognostic factors for survival. Multiple factors analysis results showed that age, disease length, pathological type were 5 years OS related factors, and age, disease length, different treatment methods were DFS related factors, only lesions length was DMFS related factors, lesion length, different chemotherapy method was DMFS related factors of survival. The rate of serious adverse reaction of the chemoradiotherapy group was higher than radiotherapy group, the difference had statistical significance. Conclusion The chemoradiotherapy increase DFS rate, and at the same time, the incidence of adverse reaction also increases, but 5 years OS rate doesn＂ t increased obviously.
出处
《肿瘤研究与临床》
CAS
2013年第6期378-381,共4页
Cancer Research and Clinic
关键词
食管肿瘤
放射疗法
计算机辅助
药物疗法
预后
Esophogeal neoplasms
Radiothrapy, computer-assisted
Drug therapy
Prognosis
