摘要
目的分析胸上段食管鳞癌患者根治性放疗的预后和失败因素。方法分析2004年2月至2016年12月福建省肿瘤医院收治的216例胸上段食管鳞癌根治性放疗患者的总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS),并对相关预后及治疗失败因素进行分析。结果全组患者的1、3、5年PFS分别为56.9%(123/216)、33.3%(72/216)、29.2%(63/216),1、3、5年OS分别为93.1%(201/216)、57.4%(124/216)、34.3%(74/216)。单因素分析结果显示:T分期、N分期、TNM分期、肿瘤长度、食管大体肿瘤体积(gross tumor volume,GTV)是影响胸上段食管鳞癌患者OS的预后因素(P<0.05);N分期、TNM分期、肿瘤长度、GTV是影响胸上段食管鳞癌患者PFS的预后因素(P<0.05)。多因素分析结果显示:N分期、GTV是影响胸上段食管鳞癌患者PFS的独立预后因素(P<0.05);N分期、化疗、GTV是影响胸上段食管鳞癌患者OS的独立预后因素(P<0.05)。全组局部总复发率31.9%,其中原发灶复发率18.5%、区域淋巴结转移率16.2%,全组远处转移率28.2%。结论N分期、化疗、GTV是胸上段食管鳞癌根治性放疗患者OS的独立预后因素,N分期、GTV是PFS的独立预后因素,主要的失败因素是局部复发和远处转移。
Objective To analyze the prognostic and failure factors of radical radiotherapy for upper thoracic esophageal squamous cell carcinoma.Methods The overall survival(OS)and progression–free survival(PFS)of 216 patients with upper thoracic esophageal squamous cell carcinoma undergoing radical radiotherapy in Fujian Cancer Hospital from February 2004 to December 2016 were analyzed,the prognostic and treatment failure factors were analyzed.Results The 1-year,3-year,and 5-year PFS of all the patients were 56.9%(123/216),33.3%(72/216),and 29.2%(63/216),respectively.The 1-year,3-year,and 5-year OS were 93.1%(201/216),57.4%(124/216),and 34.3%(74/216),respectively.Univariate analysis showed that T stage,N stage,TNM stage,tumor length and gross tumor volume(GTV)were prognostic factors affecting OS in patients with upper thoracic esophageal cancer(P<0.05).N stage,TNM stage,tumor length,and GTV were prognostic factors affecting PFS in patients with upper thoracic esophageal cancer(P<0.05).Multivariate analysis showed that N stage,and GTV were independent prognostic factors for PFS in patients with upper thoracic esophageal cancer,N stage,chemotherapy and GTV were independent prognostic factors for OS in patients with upper thoracic esophageal cancer.The overall local recurrence rate was 31.9%,included primary recurrence(18.5%),regional lymph node metastasis(16.2%),and distant metastasis(28.2%).Conclusion N stage,chemotherapy and GTV are independent prognostic factors for OS,while N stage and GTV are independent prognostic factors for PFS,the two main failure factor are local recurrence and distant metastases.
作者
林珺
陈俊强
林宇
黄秋远
LIN Jun;CHEN Junqiang;LIN Yu;HUANG Qiuyuan(Department of Radiation Oncology,Fujian Cancer Hospital,Clinical Oncology School of Fujian Medical University,Fuzhou 350000,Fujian,China;Department of Radiation Oncology,Fujian Maternity and Child Health Hospital,Fuzhou 350000,Fujian,China)
出处
《中国现代医生》
2023年第15期1-4,共4页
China Modern Doctor
基金
福建省自然科学基金项目(2021J01428)。
关键词
胸上段食管鳞癌
根治性放疗
预后
失败因素
Upper thoracic esophageal squamous cell carcinoma
Radical radiotherapy
Prognosis
Failure factor
