Chen Er-Cheng, Liu Meng-Zhong, Hu Yong-Hong, Li Qiao-Qiao, Liu Hui, Cai Ling, Liu Hui, Lin Huan-Xin, Huang Ying, Wang Han-Yu, Cui Nian-Ji
Department of Radiotherapy Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, P. R. China.
Ai Zheng. 2005 Jun;24(6):731-4.
BACKGROUND & OBJECTIVE: Concurrent chemoradiotherapy is recommended as standard treatment for unresectable esophageal carcinoma now. This study was to analyze the prognostic factors of unresectable esophageal carcinoma after concurrent chemoradiotherapy.
A total of 132 unresectable esophageal carcinoma patients received concurrent chemoradiotherapy from Jan. 1996 to Dec. 2003 in our hospital. All patients received chemotherapy at the beginning of radiotherapy, and when the radiation dose escalated to 40 Gy. Total dose of irradiation was 60-70 Gy. Gender, age, disease course, focus location, swallow embarrassment, weight loss, Karnofsky's performance status (KPS) score, family history, hemoglobin (HB) before therapy, X-ray type, pathologic grade, focus length, TNM stage, irradiation method and technology, irradiation dose, radiotherapy interval, short-term effect, esophagus perforation, esophagus haemorrhage, and retreatment methods were used as analysis factors for Cox regression univariate and multivariate analyses.
Univariate analysis showed that diseases course, focus location, weight loss, M stage, short-term effect, esophagus perforation, esophagus haemorrhage, and retreatment methods were prognostic factors of these patients. Multivariate analysis showed that M stage [P=0.014, odds ratio (OR)=2.515], short-term effect (P < 0.001, OR=2.181), esophagus perforation (P=0.022, OR=3.266), and retreatment methods (P=0.026, OR=1.142) were independent prognostic factors.
The main prognostic factors of the patients with unresectable esophageal carcinoma treated with concurrent chemoradiotherapy are M stage, short-term effect, esophagus perforation, and retreatment methods.
目前,同步放化疗被推荐为不可切除食管癌的标准治疗方法。本研究旨在分析同步放化疗后不可切除食管癌的预后因素。
1996年1月至2003年12月,我院共有132例不可切除食管癌患者接受同步放化疗。所有患者在放疗开始时接受化疗,当放射剂量增至40 Gy时。总照射剂量为60 - 70 Gy。将性别、年龄、病程、病灶部位、吞咽困难、体重减轻、卡氏功能状态(KPS)评分、家族史、治疗前血红蛋白(HB)、X线类型、病理分级、病灶长度、TNM分期、照射方法与技术、照射剂量、放疗间隔、近期疗效、食管穿孔、食管出血及再治疗方法作为Cox回归单因素和多因素分析的因素。
单因素分析显示,病程、病灶部位、体重减轻、M分期、近期疗效、食管穿孔、食管出血及再治疗方法是这些患者的预后因素。多因素分析显示,M分期[P = 0.014,比值比(OR)=