| 王修身,卜珊珊,习 勉.颈段食管鳞癌根治性同期放化疗的临床疗效分析[J].中国肿瘤,2018,27(7):541-546. |
| 颈段食管鳞癌根治性同期放化疗的临床疗效分析 |
| Clinical Efficacy in Cervical Esophageal Squamous Cell Carcinoma Treated with Definitive Concurrent Chemoradiotherapy |
| 投稿时间：2018-03-15 |
| DOI：10.11735/j.issn.1004-0242.2018.07.A011 |
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| 中文关键词: 颈段食管癌 同期放化疗 适形放疗 复发模式 |
| 英文关键词:cervical esophageal cancer concurrent chemoradiotherapy conformal radiotherapy failure pattern |
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| 中文摘要: |
| 摘 要：［目的］分析颈段食管鳞癌根治性同期放化疗的临床疗效及失败模式，并探讨临床相关因素对其预后的影响。［方法］回顾性分析2002年至2014年接受根治性放化疗的颈段食管鳞癌患者100例。放疗中位剂量为60 Gy（50～70Gy），常规分割，其中54例（54.0%）采用三维适形放射治疗（three-dimensional conformal radiotherapy，3DCRT），46例（46.0%）采用调强放射治疗（intensity-modulated radiotherapy，IMRT）；化疗采用以铂类为基础的化疗方案。采用Kaplan-Meier法进行生存分析，Log-rank检验进行组内分析，Cox回归模型进行多因素分析。［结果］全组中位随访时间47.0个月（3.8～128.0个月），5年总生存率(overall survival，OS)、无进展生存率（progression-free survival，PFS）、无局部区域复发生存率（locoregional failure-free survival，LRFFS）分别为33.2%、31.5%、32.1%。截至末次随访日期，共31例（31.0%）患者出现局部复发，25例（25.0%）出现区域复发，41例（41.0%）发生远处转移。多因素分析显示，性别、声嘶是影响OS（HR=2.015，P=0.01；HR=3.736，P<0.001）和PFS（HR=2.064，P=0.007；HR=3.583，P= 0.001）的独立预后因素，而声嘶是影响LRFFS的唯一的不良预后因素（HR=2.884，P=0.002）。［结论］颈段食管癌根治性放化疗后可获得较高的局部区域控制率，远处转移为其主要失败模式。声嘶是颈段食管鳞癌不良预后因素。 |
| 英文摘要: |
| Abstract：［Purpose］ To analyze the clinical efficacy and failure pattern in patients with cervical esophageal squamous cell carcinoma undergoing definitive concurrent chemoradiotherapy，and to investigate the potential prognostic factors related to survival. ［Methods］ Between 2002 and 2014，100 patients with cervical esophageal squamous cell carcinoma treated with definitive concurrent chemoradiotherapy were included for analysis. All patients received concurrent platinum-based chemotherapy with conformal radiotherapy. The median radiation dose was 60Gy(50～70Gy) with conventional fractionation，including 54 patients(54.0%) treated with three-dimensional conformal radiotherapy and 46 patients(46.0%) treated with intensity-modulated radiotherapy. Kaplan-Meier method was used to analyze the survival，the log-rank test was used to examine group differences，and the Cox regression model was used for multivariate analysis. ［Results］ The median follow-up time was 47 months(3.8～128.0 months)，and the 5-year overall survival(OS)，progression-free survival(PFS)，and locoregional failure-free survival(LRFFS) rates for the entire group were 33.2%，31.5% and 32.1%，respectively. At the deadline of analysis，31(31.0%)，25(25.0%)，and 41 patients(41.0%) developed local，regional，and distant recurrences，respectively. Multivariate analysis revealed that gender and hoarseness were independent prognostic indicators for OS(HR=2.015，P=0.01；HR=3.736，P<0.001) and PFS(HR=2.064，P=0.007；HR=3.583，P=0.001). Hoarseness was the only independent prognostic factor for LRFFS(HR=2.884，P=0.002). ［Conclusion］ High locoregional control rate could be obtained in cervical esophageal squamous cell carcinoma patients after definitive concurrent chemoradiotherapy，whereas distant metastasis is the most common failure pattern. Hoarseness is an independent prognostic factor for poor survival. |
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