文章摘要
刘 佳,崔 珍,孙巧玉,江 浩,李多杰,樊晓玓.放疗剂量对颈段食管癌疗效的影响及预后因素分析[J].南京医科大学学报,2021,(4):557~563
放疗剂量对颈段食管癌疗效的影响及预后因素分析
Effects of radiotherapy dose on cervical esophageal carcinoma and related prognosic factors analysis
投稿时间:2020-10-29  
DOI:10.7655/NYDXBNS20210414
中文关键词: 颈段食管癌  放射治疗  预后  复发
英文关键词: cervical esophageal carcinoma  radiation therapy  prognosis  recurrence
基金项目:安徽省高等学校自然科学研究重点项目(KJ2019A0357);安徽省临床重点专科建设项目;蚌埠医学院研究生科研创新计划(BYYCX1967)
作者单位
刘 佳 蚌埠医学院第一附属医院肿瘤放疗科安徽 蚌埠 233000 
崔 珍 蚌埠医学院第一附属医院肿瘤放疗科安徽 蚌埠 233000 
孙巧玉 蚌埠医学院第一附属医院肿瘤放疗科安徽 蚌埠 233000 
江 浩 蚌埠医学院第一附属医院肿瘤放疗科安徽 蚌埠 233000 
李多杰 蚌埠医学院第一附属医院肿瘤放疗科安徽 蚌埠 233000 
樊晓玓 蚌埠医学院第一附属医院肿瘤放疗科安徽 蚌埠 233000 
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中文摘要:
      目的:观察放疗剂量对颈段食管癌(cervical esophageal carcinoma,CEC)疗效的影响,并对CEC的预后因素进行分析。方法:回顾性分析2013—2018年收治的96例接受三维适形放疗或调强放疗的CEC患者,依据大体肿瘤放疗剂量分为低剂量组(≤60 Gy)、中剂量组(>60~<66 Gy)及高剂量组(≥66 Gy),比较各组临床疗效、急性不良反应及治疗失败模式的差异,并分析CEC患者的相关预后因素。结果:放疗结束后1个月观察近期疗效,3组的有效率分别为66.7%、85.4%、85.7%,差异无统计学意义(P=0.114);单因素分析显示放疗剂量是总生存(overall survival,OS)(P=0.031)、无进展生存(progression?free survival,PFS)(P=0.045)、无局部区域进展生存(local?regional failure?free survival,LRFFS)(P=0.020)的影响因素,中、高剂量组疗效无差异,且均较低剂量组好(P<0.05)。CEC OS的独立预后因素是放疗剂量、是否同步化疗及邻近器官是否受侵。结论:CEC采用根治性放化疗可获得较好疗效,中剂量即>60~<66 Gy可能是CEC更为合理的放疗剂量;放疗剂量、是否同步化疗及邻近器官是否受侵是CEC OS的独立预后因素。
英文摘要:
      Objective:To observe the effect of radiotherapy dose on cervical esophageall carcinoma,and to analyze the prognostic factors of cervical esophageal carcinoma. Methods:A retrospective analysis was performed on 96 patients with cervical esophageal carcinoma who received three dimensional conformal radiation therapy or intensity?modulated radiation therapy from 2013 to 2018 according to inclusion criteria. All the patients are divided into three groups according to the radiation dose of gross tumor:the low?dose group(≤60 Gy),the medium?dose group(>60~<66 Gy)and the high?dose group(≥66 Gy)respectively. The clinical effect,acute adverse effects,and treatment failure mode were compared among three groups,and the prognostic factors of cervical esophageal carcinoma were analyzed. Results:The short?term efficacy was observed one month after radiotherapy,and the objective response rate was 66.7%,85.4%,and 85.7%,respectively. There was no statistical difference among three groups(P=0.114). The univariate analysis showed that radiotherapy dose was the influencing factor of overall survival(P=0.031),progression?free survival(P=0.045)and local?regional failure?free survival(P=0.020),and there was no difference in the efficacy between the middle?dose group and the high?dose group,and all of them better than the low?dose group(P<0.05). The independent prognostic factors of OS for cervical esophageal carcinoma are radiotherapy dose,synchronous chemotherapy,and invasion of adjacent organs. Conclusion:Radical chemoradiotherapy is effective for cervical esophageal cancer,and the medium dose,i.e. >60~<66 Gy,may be a more reasonable radiotherapy dose for cervical esophageal cancer. Radiotherapy dose,concurrent chemotherapy and invasion of adjacent organs are independent prognostic factors of OS.
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