吴盛喜,罗何三,许鸿鹞.327例临床T4期食管癌放疗患者的疗效及预后因素分析[J].肿瘤学杂志,2017,23(12):1064-1068.
327例临床T4期食管癌放疗患者的疗效及预后因素分析
Response and Prognostic Factors in 327 Cases with Stage T4 Esophageal Cancer Based on Non-surgical Clinical Staging After Radiotherapy
投稿时间:2017-07-19  
DOI:10.11735/j.issn.1671-170X.2017.12.B004
中文关键词:  食管肿瘤  T4期  辅助化疗  放疗  预后
英文关键词:esophageal cancer  stage T4  chemoradiotherapy  adjuvant chemotherapy  prognosis
基金项目:广东省科技计划项目(2016ZC0250)
作者单位
吴盛喜 汕头市中心医院 
罗何三 汕头市中心医院 
许鸿鹞 汕头市中心医院 
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中文摘要:
      摘 要: [目的] 分析临床T4期食管癌患者放疗的疗效及预后影响因素,探讨指导该患者人群治疗的最佳方式。[方法] 回顾性分析接受放疗和同期放化疗的T4期食管癌患者327例,采用Kaplan-Meier法计算生存率,分析远期疗效,并采用单因素和COX多因素分析影响患者预后的因素。[结果] 全组中位随访时间12.43个月,全组1、2、3和5年生存率分别为51.6%、22.0%、14.9%和10.3%。单因素分析显示是否行辅助化疗(P=0.004)及N分期(P=0.026)与患者预后相关;COX多因素分析显示,是否行辅助化疗(P=0.006)及N分期(P=0.029)是影响患者的独立预后因素。[结论] 在临床T4期食管癌中,同期放化疗并不影响患者预后,是否行辅助化疗及N分期可为局部晚期T4期食管癌预后判断提供依据,指导临床实践。
英文摘要:
      Abstract:[Objective] To investigate the response and prognostic factors in patients with stage T4 esophageal cancer according to non-surgical clinical staging after radiotherapy,and to explore the most optimal treatment for these patients. [Methods] A total of 327patients who hadStage T4 esophageal cancer according to non-surgical clinical stagingand received radiotherapy and adjuvant chemoradiotherapy were retrospectively analyzed. The survival rate was calculated usingthe Kaplan-Meier method. The Cox regression model was used for invariant analysis and multivariate analysis. [Results] The median follow up time was 12.43 months. The 1-,2-,3-,and 5-year survival rate was 51.6%,22.0%,14.9%,and 10.3%,respectively. In univariant analysis,the use of adjuvant chemotherapy(P=0.004) and N-staging(P=0.029) was related with the prognosis of the patients havingStage T4 esophageal cancer. The COX regression model showed that adjuvant chemotherapy(P=0.006) and N-staging(P=0.026) were independent prognostic factors that affected the survival rate. [Conclusion] In patients who hadStage T4 esophageal cancer based on non-surgical clinical staging,concurrent chemoradiotherapy did not improve the survival rate.Adjuvant chemotherapy and N-staging could provide evidence for prognosis evaluation and clinical practice.
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