Page 87 - 南京医科大学学报自然科学版

第41卷第4期 南京医科大学学报（自然科学版）
2021年4月 Journal of Nanjing Medical University（Natural Sciences） ·557 ·

·临床医学·

放疗剂量对颈段食管癌疗效的影响及预后因素分析

刘 佳，崔 珍 ，孙巧玉，江 浩，李多杰，樊晓玓
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蚌埠医学院第一附属医院肿瘤放疗科，安徽 蚌埠 233000

［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。
［关键词］ 颈段食管癌；放射治疗；预后；复发
［中图分类号］ R735.1 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）04⁃557⁃07
doi：10.7655/NYDXBNS20210414

Effects of radiotherapy dose on cervical esophageal carcinoma and related prognosic

factors analysis
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LIU Jia，CUI Zhen ，SUN Qiaoyu，JIANG Hao，LI Duojie，FAN Xiaodi
Department of Radiotherapy，the First Affiliated Hospital of Bengbu Medical College，Bengbu 233000，China

［Abstract］ 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.
［Key words］ cervical esophageal carcinoma；radiation therapy；prognosis；recurrence
［J Nanjing Med Univ，2021，41（04）：557⁃563］
［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）
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通信作者（Corresponding author），E⁃mail：15955003435@163.com