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食管癌放射治疗10年生存分析及不同治疗方式的疗效比较

孔雁, 高红梅

孔雁, 高红梅. 食管癌放射治疗10年生存分析及不同治疗方式的疗效比较[J]. 肿瘤防治研究, 2015, 42(01): 56-61. DOI: 10.3971/j.issn.1000-8578.2015.01.014
引用本文: 孔雁, 高红梅. 食管癌放射治疗10年生存分析及不同治疗方式的疗效比较[J]. 肿瘤防治研究, 2015, 42(01): 56-61. DOI: 10.3971/j.issn.1000-8578.2015.01.014
KONG Yan, GAO Hongmei. Long Outcome of Radiotherapy for Esophageal Carcinoma and Efficacy Comparison of Different Treatment Methods[J]. Cancer Research on Prevention and Treatment, 2015, 42(01): 56-61. DOI: 10.3971/j.issn.1000-8578.2015.01.014
Citation: KONG Yan, GAO Hongmei. Long Outcome of Radiotherapy for Esophageal Carcinoma and Efficacy Comparison of Different Treatment Methods[J]. Cancer Research on Prevention and Treatment, 2015, 42(01): 56-61. DOI: 10.3971/j.issn.1000-8578.2015.01.014

食管癌放射治疗10年生存分析及不同治疗方式的疗效比较

详细信息
    作者简介:

    孔雁(1980-),女,硕士,主治医师,主要从事肿瘤综合治疗的研究

    通讯作者:

    高红梅,E-mail: kongyan8008@sina.com

  • 中图分类号: R735.1

Long Outcome of Radiotherapy for Esophageal Carcinoma and Efficacy Comparison of Different Treatment Methods

  • 摘要: 目的 分析食管癌患者放射治疗10年的生存情况及三维适形放射治疗(3D-CRT)、后程加速超分割放射治疗(LCAF)及常规二维放射治疗(CF)三种不同治疗方式的疗效比较。方法 收集2000年10月—2003年3月在河北医科大学第四医院接受根治性放射治疗的170例食管癌患者进行回顾性分析,分析放疗疗效、预后影响因素、失败模式、不良反应和生活质量。结果 全组患者3、5、10年生存率分别为30.59%、24.12%和11.76%。3D-CRT、LCAF及CF组患者生存率差异无统计学意义(χ2=2.41Ρ=0.2990)。多因素分析结果显示治疗前有无胸背部疼痛、临床分期、有无软组织影和≥2级放射性食管炎(radiation esophagitis, RE)为患者独立预后影响因素。三组患者中复发和转移发生率差异均无统计学意义(χ2 =4.619,P=0.099,χ2 =3.221,P=0.200)。三组患者≥2级急性RE和≥2级急性放射性肺炎(radiation pneumonia, RP)的发生率差异无统计学意义(χ2 =0.442、4.281,P=0.802、0.118),但3D-CRT与LCAF两组间≥2级急性RP的发生率差异有统计学意义(χ2=4.306,P=0.038)。截至随访时间共有20例患者生存,多数患者生存状态良好。结论 食管癌放射治疗为非手术治疗食管癌患者的有效治疗手段;区域性复发及远处转移仍为患者的主要失败模式;与LCAF相比,3D-CRT能明显降低2级以上RP的发生率。

     

    Abstract: Objective To analyze the long outcome of radiotherapy for esophageal carcinoma and,compare the efficacy of different treatment methods. Methods We retrospectively analyzed 170 esophageal carcinoma patients who received radical radiotherapy from Oct. 2000 to Mar. 2003 Radiotherapy efficacy, prognostic factors, failure mode, side effect and quality of life(QOL) were analyzed. Results The 3-, 5- and 10-year survival rates were 30.59%, 24.12% and 11.76% respectively. There were no statistically significant differences in survival rates among 3-dimensional conformal radiotherapy(3D-CRT) group, late course accelerated hyperfraction(LCAF) group and conventional fraction radiotherapy(CF) group (χ2=2.41, P=0.2990). Multivariate analysis showed that with or without chest pain before treatment, clinical stage, presence of soft tissue shadow and ≥grade 2 radiation esophagitis (RE) were independent prognosis factors. There were no statistically significant differences in recurrence or metastasis rates among different groups (χ2=4.619, P=0.099, χ2=3.221, P=0.200). There were no statistically differences in ≥grade 2 RE or ≥grade 2 radiation pneumonia (RP) between different groups (χ2=0.442, 4.281;P=0.802,0.118); while there were significant differences in incidence rates of ≥grade 2 RP between 3D-CRT and LCAF group (χ2=4.306, P=0.038). QOL was good in living patients. Conclusion The long-term outcome of esophageal carcinoma patients who received radiotherapy is good. Regional recurrence and distant metastasis are still the main failure modes. Compared with LCAF, 3D-CRT could significantly reduce the incidence rate of ≥grade 2 RP.

     

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出版历程
  • 收稿日期:  2013-11-28
  • 修回日期:  2014-04-23
  • 刊出日期:  2015-01-24

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