高级搜索

食管癌AJCC/UICC第6、7版TNM分期分段方法在放疗患者中的比较

周志国, 甄婵军, 梁军利, 张萍, 刘欣, 白文文, 乔学英, 宋玉芝, 高献书

周志国, 甄婵军, 梁军利, 张萍, 刘欣, 白文文, 乔学英, 宋玉芝, 高献书. 食管癌AJCC/UICC第6、7版TNM分期分段方法在放疗患者中的比较[J]. 肿瘤防治研究, 2015, 42(08): 772-776. DOI: 10.3971/j.issn.1000-8578.2015.08.005
引用本文: 周志国, 甄婵军, 梁军利, 张萍, 刘欣, 白文文, 乔学英, 宋玉芝, 高献书. 食管癌AJCC/UICC第6、7版TNM分期分段方法在放疗患者中的比较[J]. 肿瘤防治研究, 2015, 42(08): 772-776. DOI: 10.3971/j.issn.1000-8578.2015.08.005
ZHOU Zhiguo, ZHEN Chanjun, LIANG Junli, ZHANG Ping, LIU Xin, BAI Wenwen, QIAO Xueying, SONG Yuzhi, GAO Xianshu. Comparison of 6th and 7th Editions of AJCC/UICC TNM Staging for Esophageal Cancer Patients Received Radiotherapy[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 772-776. DOI: 10.3971/j.issn.1000-8578.2015.08.005
Citation: ZHOU Zhiguo, ZHEN Chanjun, LIANG Junli, ZHANG Ping, LIU Xin, BAI Wenwen, QIAO Xueying, SONG Yuzhi, GAO Xianshu. Comparison of 6th and 7th Editions of AJCC/UICC TNM Staging for Esophageal Cancer Patients Received Radiotherapy[J]. Cancer Research on Prevention and Treatment, 2015, 42(08): 772-776. DOI: 10.3971/j.issn.1000-8578.2015.08.005

食管癌AJCC/UICC第6、7版TNM分期分段方法在放疗患者中的比较

详细信息
    作者简介:

    周志国(1977-),男,硕士,副主任医师,主要从事恶性肿瘤的放疗等综合治疗

    通讯作者:

    乔学英,E-mail:chenk777@126.com

  • 中图分类号: R735.1

Comparison of 6th and 7th Editions of AJCC/UICC TNM Staging for Esophageal Cancer Patients Received Radiotherapy

  • 摘要: 目的 探讨食管癌AJCC/UICC第6、第7版分期中分段方式在放射治疗患者中应用的合理性及对预后的影响。方法 对符合入组条件的265例食管癌放射治疗患者进行回顾分析,依照AJCC/UICC2009年第7版食管癌TNM分期标准及第6版食管癌TNM分期标准中的分段方法,进行分段比较分析,并进行单因素、多因素生存分析。结果 按照AJCC/UICC第7版食管癌TNM分期中的分段标准,食管原发灶位于颈段46例、胸上段76例、胸中段83例、胸下段60例。按照第6版食管癌TNM分期中分段标准,食管原发灶位于颈段16例、胸上段83例、胸中段132例、胸下段34例。根据两种分段结果是否一致分为两组:一致组(169例)及差异组(96例),一致组中颈段及胸上、中、下段食管癌患者1、2、3年生存率分别为70.6%、64.7%、64.7%;84.3%、57.8%、53.6%;53.4%、32.7%、21.0%及71.4%、40.2%、40.2%(P=0.001)。差异组中,各段生存率未见差异。Cox回归模型多因素生存分析,结果显示第6版分期的分段方式及放疗剂量对预后的影响有统计学意义。结论 两种分期方法对颈段、胸中段、胸下段食管癌的判定差异较大,第6版分期标准中的分段方法可以较好预测放疗患者的生存,颈段、胸上段食管癌患者放疗后生存优于胸中、下段食管癌患者。

     

    Abstract: Objective To evaluate the reasonability of the 6th and 7th editions of American Joint Committee on Cancer/Union for International Cancer Control(AJCC/UICC) tumor node metastasis(TNM) staging foresophageal carcinoma in radiotherapy and their effect on prognosis. Methods We retrospectively analyzed 265 esophageal carcinoma patients received radiotherapy. In accordance with different definition about location segment in the 6th and 7th edition of AJCC/UICC TNM staging for esophageal carcinoma, we analyzed and evaluated the prognosis by univariate and multivariate survival analysis. Results According to the 7th edition of AJCC/UICC TNM staging for esophageal carcinoma, the number of esophagus primary lesions in cervical, upper, middle and inferior thoracic portion were 46, 76, 83 and 60, respectively, according to the 6th edition, the number were 16, 83, 132 and 34, respectively. All patients were divided into two groups according to the two methods, the consistent group (169 cases) and the difference group (96 cases). In consistent group, the 1-, 2-, 3-year survival rates of patients with esophageal carcinoma in cervical, upper, middle and inferior thoracic portion were 70.6%, 64.7%, 64.7%;84.3%, 57.8%, 53.6%;53.4%, 32.7%, 21.0% and 71.4%, 40.2%, 40.2%, respectively(P=0.001). The difference wasn't signi?cant statistically in the difference group. Multivariate analysis showed that age, the 6th edition of TNM staging and radiation dose were independent factors for the survival. Conclusion The difference of two staging methods on the esophageal carcinoma in cervical, middle and inferior thoracic portion is obvious. The 6th edition of AJCC/UICC TNM staging could better predict the survival. The survival of patients with esophageal carcinoma in cervical and upper thoracic portion after radiotherapy is superior to those in the middle and inferior thoracic portion.

     

  • [1] Rice TR, Blackstone EH, Rusch VW. 7th Edition of the AJCC cancer staging manual: esophagus and esophagogastric junction[J]. Ann Surg Oncol, 2010, 17(7): 1721-4.
    [2] Chen LQ. Defining AJCC/UICC esophageal cancer TNM stag ing 7t h edition(2009)[J]. Zhongguo Xiong Xin Xue Guan Wai Ke Lin Chuang Za Zhi, 2008, 15(1): 52-5. [陈龙奇. 制订2009第7版食管 癌TNM分期标准[J]. 中国胸心血管外科临床杂志, 2008, 15(1): 52 -5.]
    [3] Talsma K, van Hagen P, Grotenhuis BA, et al. Comparison of the 6t h and 7th Editions of the UICC-AJCC TNM Classification for Esophageal Cancer[J]. Ann Surg Oncol, 2012, 19(7): 2142-8.
    [4] He J, Wang JJ, Qian JX, et al. Comparison of the predictive value of the 6th and the 7th editions of the UICC-AJCC TNM staging systems in prognosis of esophageal cancer after radical resection: Analysis of 400 patients with esophageal cancer[J]. Zhong Liu, 2013, 33(2): 164-70. [何健, 王杰军, 钱建 新, 等. 第6版和第7版UICC-AJCC TNM分期系统预测食管癌 根治性切除术后生存情况的比较:基于400例食管癌患者的临 床分析[J]. 肿瘤, 2013, 33(2): 164-70. ]
    [5] Yang JS, Yang WP, Chen YP, et al. Operative treatment of 306 cases with high esophageal careinoma[J]. Lin Chuang Zhong Liu Xue Za Zhi, 1999, 4(3): 18-9. [杨捷生, 杨卫平, 陈于平, 等. 手术治疗高位食管癌306例[J]. 临床肿瘤学杂志, 1999, 4(3): 18-9.]
    [6] Wang WG, Li JD, Qi JX, et al. Experence of surgical treatment for cervical esophageal carcinoma[J]. Zhonghua Wei Chang Wai Ke Za Zhi, 2008, 11(1): 19-23. [王文光, 李进东, 齐金星, 等. 颈段食 管癌的外科治疗[J].中华胃肠外科杂志, 2008, 11(1): 19-23. ]
    [7] Zhu SC, Li R, Wang YX, et al. Prognostic factors of locally advanced esophageal carcinoma treated by radiotherapy alone[J]. Zhonghua Fang She Zhong Liu Xue Za Zhi, 2005, 14(4): 253-8. [祝淑钗, 李任, 王玉祥, 等. 500例中晚期食管癌单纯放疗的多 因素分析[J]. 中华放射肿瘤学杂志, 2005, 14(4): 253-8. ]
    [8] Wang L, Kong J, Han C, et al. Prognositic analysis of cervical, upper-thoracic, middle-thoracic, and lower-thoracic esophageal cancers in 781 patients mainly receiving three-dimensional radiotherapy[J]. Zhonghua Fang She Zhong Liu Xue Za Zhi, 2013, 22 (1): 18-21. [王澜, 孔洁, 韩春, 等. 781例不同部位食管癌三维 放疗预后分析[J]. 中华放射肿瘤学杂志, 2013, 22(1): 18-21.]
    [9] Wang YX, Zhu SC, Su JW, et al. Prognostic analysis of threedimensional conformal radiotherapy(3D-CRT)for cervical and upper-thoracic esopageal cancer[J]. Zhong Liu Fang Zhi Yan Jiu, 20 11, 38(1): 93-7. [王玉祥, 祝淑钗, 苏景伟, 等. 颈及胸上段 食管癌三维适形放射治疗疗效分析[J]. 肿瘤防治研究, 2011, 38 (1): 93-7. ]
    [10] Xiao ZF, Yang ZY, Wang LH, et al. Influence of the number of lymph node metastasis on survival and significance of postoperative radiotherapy for esophageal carcinoma[J]. Zhonghua Zhong Liu Za Zhi, 2004, 26(2): 112-5. [肖泽芬, 杨宗 贻, 王绿化, 等. 食管癌术后淋巴结转移对生存率的影响和放射 治疗的意义[J]. 中华肿瘤杂志, 2004, 26(2): 112-5. ]
    [11] Li CL, Wang YD. Lymphnode metastasis of thoracic esophageal cancer after lymphnode dissection:providing guidance for postoperative radiotherapy target[J]. Zhong Liu Fang Zhi Yan Jiu, 20 11, 38(11): 1332-4. [李成林, 王雅棣. 食管癌术后淋巴结转移 规律及放疗靶区探讨[J]. 肿瘤防治研究, 2011, 38(11): 1332-4. ]
    [12] Zhen CJ, Zhou ZG, Qiao XY, et al. Retrospective study on staging of esophageal cancer with supra-clavicular lymph node metastasis:an anaylsis of 152 cases[J]. Zhongguo Zhong Liu Lin Chuang, 2011, 38(23): 1458-63. [甄婵军, 周志国, 乔学英, 等. 第 7版 食管癌锁骨上淋巴结转移分期方式的探讨及152例病例分 析[J] 中国肿瘤临床, 2011, 38(23): 1458-63. ]
    [13] Liu W, Hao XS, Chen Y, et al. Lymph node metastases from carcinoma of the thoracic esophagus and cardia: a random sampling report of 1 526 cases[J]. Zhongguo Zhong Liu Lin Chuang, 2008, 35(11): 601-6. [刘巍, 郝希山, 陈勇, 等. 1 526例 胸段食管癌及贲门癌淋巴结转移状况分析(附1996~2004年河 北医科大学第四医院随机抽样报告)[J]. 中国肿瘤临床, 2008, 35 (11): 601-6.]
    [14] Zhen CJ, Zhou ZG, Song YZ, et al. Analysis of therapeutic effect and prognosis of radiotherapy for patients with esophageal carcinoma with supraclavicular lymph node metastasis[J]. Zhong Liu Fang Zhi Yan Jiu, 2013, 40(1): 90-4. [甄婵军, 周志国, 宋玉 芝, 等. 食管癌锁骨上淋巴结转移
计量
  • 文章访问数:  2111
  • HTML全文浏览量:  400
  • PDF下载量:  761
  • 被引次数: 0
出版历程
  • 收稿日期:  2014-09-04
  • 修回日期:  2015-02-09
  • 刊出日期:  2015-08-24

目录

    /

    返回文章
    返回
    x 关闭 永久关闭