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老年食管癌三维适形与调强放射治疗疗效比较

王玉祥, 王军, 祝淑钗, 田丹丹, 吕冬捷, 王祎, 乔学英

王玉祥, 王军, 祝淑钗, 田丹丹, 吕冬捷, 王祎, 乔学英. 老年食管癌三维适形与调强放射治疗疗效比较[J]. 肿瘤防治研究, 2012, 39(08): 1008-1013. DOI: 10.3971/j.issn.1000-8578.2012.08.031
引用本文: 王玉祥, 王军, 祝淑钗, 田丹丹, 吕冬捷, 王祎, 乔学英. 老年食管癌三维适形与调强放射治疗疗效比较[J]. 肿瘤防治研究, 2012, 39(08): 1008-1013. DOI: 10.3971/j.issn.1000-8578.2012.08.031
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Wang Yuxiang, Wang Jun, Zhu Shuchai, Tian Dandan, Lv Dongjie, Wang Yi, Qiao Xueying. Comparison of Prognosis on Esopageal Carcinoma Treated with 3D-CRT and IMRT for Elderly Patients[J]. Cancer Research on Prevention and Treatment, 2012, 39(08): 1008-1013. DOI: 10.3971/j.issn.1000-8578.2012.08.031
Citation: Wang Yuxiang, Wang Jun, Zhu Shuchai, Tian Dandan, Lv Dongjie, Wang Yi, Qiao Xueying. Comparison of Prognosis on Esopageal Carcinoma Treated with 3D-CRT and IMRT for Elderly Patients[J]. Cancer Research on Prevention and Treatment, 2012, 39(08): 1008-1013. DOI: 10.3971/j.issn.1000-8578.2012.08.031
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老年食管癌三维适形与调强放射治疗疗效比较

  • 050011石家庄,河北医科大学第四医院放疗科

基金项目: 河北省卫生厅资助课题(06004,08162)
详细信息
    作者简介:

    王玉祥(1969-),男,博士,副教授,主要从事食管癌放疗的基础及临床研究

    通讯作者:

    王军,E-mail:wangyuxiang69@sohu.com

  • 中图分类号: R735.1；R730.55

Comparison of Prognosis on Esopageal Carcinoma Treated with 3D-CRT and IMRT for Elderly Patients

  • Department of Radiation Oncology,The Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China

摘要

    摘要
  • 摘要: 目的 比较老年食管癌三维适形放射治疗(3D-CRT)或调强放疗(IMRT)的疗效及其预后相关因素。方法回顾性分析153例65岁以上老年食管癌患者的临床资料,105例行3D-CRT、48例行IMRT,采用SPSS11.5统计软件比较分析生存率及预后影响因素。结果放疗后食管造影评价CR 71例、PR 78例、NR 4例,总有效率(CR+PR)为97.4%;全组1、3年生存率和局部控制率分别为70.6%、34.2%和76.2%、51.1%。3D-CRT与IMRT组资料相比,IMRT组胸中下段及淋巴结转移者较多、CT食管肿瘤最大径较大、放疗剂量更高、联合化疗者更多(P<0.05);而性别、年龄、T分期、放疗前进食情况及食管造影长度两组间比较差异无统计学意义(P>0.05)。3D-CRT与IMRT组1、3年生存率和局部控制率比较，差异无统计学意义(P>0.05),分层分析中两组生存率比较，差异无统计学意义(P>0.05)。全组单因素分析显示,治疗前进食情况、病变部位、T分期、淋巴结转移与否、食管造影显示病变长度、CT肿瘤最大直径、化疗和近期疗效与预后生存有关(P<0.05);Cox多因素分析仅化疗和CT肿瘤最大直径为独立预后因素(P<0.05)。结论老年食管癌IMRT与3D-CRT比较无明显生存优势,联合化疗及肿瘤最大直径小者放疗疗效较好,但需进一步前瞻性研究。

     

    Abstract: Objective To compare the prognosis of esopageal carcinoma treated with 3-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiation therapy (IMRT) for patients older than 65 years;and to analysis the related factors affected the prognosis. Methods From January 2001 to December 2008, 105 cases of elderly patients with esopageal carcinoma were treated with 3D-CRT and 48 cases with IMRT. Local control rates, survival rates and its related prognostic factors were evaluated retrospectively with SSPS11.5 software. Results After the treatment with 3D-CRT or IMRT, there was 71 cases in CR, 78 in PR, and 4 in NR. The total efficiency (CR+PR) was 97.4%. The 1 and 3-year over-all survival rate was 70.6% and 34.2%, respectively; and the 1- and 3-year local control rate was 76.2% and 51.1%, respectively. Compared with the clinical data between 3D-CRT and IMRT, there were more patients with metastasis of lymph node, located in middle and lower-thoracic carcinoma, larger diameter of tumor in CT, higher dose of radiotherapy agents, and more patients was combination of chemotherapy in IMRT group (P<0.05). There were no significant differences in the effects of gender, age, T stage and diet before radiotherapy and lesion length bariesophagogram between the two groups (P>0.05). There were no significant differences in the 1- and 3-year survival rate and free-recurrence rate between 3D-CRT and IMRT groups(P>0.05). For all patients, analyzed by univariate analysis, the related factors affected on the prognosis were the different diet, site of lesion, T stage, metastasis of lymph node, lesion length in barium esophagogram and CT image, chemotherapy and the immediate response (P＜0.05). By Cox multivariate analysis, the independent factors affected on the prognosis were chemotherapy and the largest diameter of lesion in CT scanning image (P＜0.05). Conclusion s3D-CRT and IMRT can be considered as effective and feasible approaches for elderly patients with esophageal cancer. Chemotherapy and the largest diameter of lesion in CT scanning image were independent prognostic factors for those patients.

     

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出版历程
  • 收稿日期:  2011-10-19
  • 修回日期:  2012-02-01
  • 刊出日期:  2012-08-24

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