一项回顾性研究：原发性放化疗食管癌患者贫血、吸烟和饮酒的预后价值。
A retrospective study: the prognostic value of anemia, smoking and drinking in esophageal squamous cell carcinoma with primary radiotherapy.
机构信息
Department of Radiotherapy, Cancer Centre, Qilu Hospital, Shandong University, 107 Wenhuaxi Rd, Jinan, Shandong 250012, China.
出版信息
World J Surg Oncol. 2013 Oct 1;11:249. doi: 10.1186/1477-7819-11-249.
BACKGROUND
Few studies have investigated the relationship between anemia, smoking, drinking and survival in esophageal squamous cell carcinoma (ESCC) with primary radiotherapy. This study had the aim of evaluating the prognostic value of anemia, smoking and drinking in patients receiving primary radiotherapy for ESCC.
METHODS
A total of 79 patients who underwent radiotherapy during initial treatment for ESCC were included in this study. The 2-year overall survival (OS) and disease-free survival (DFS) were analyzed between the anemic and non-anemic groups, non-smokers and smokers, and non-drinkers and drinkers using the Kaplan-Meier method and the Cox proportional hazards model.
RESULTS
There were 79 patients (10 male) of median age 63 (range 38 to 84) years. The 2-year OS and DFS were 36% and 25%, respectively, in the non-anemic group, and 17% and 13%, respectively, in the anemic group (P = 0.019 for OS; P = 0.029 for DFS) using the Kaplan-Meier method. Survival analysis using the Kaplan-Meier method showed that the 2-year OS and DFS had no statistical difference between smoking, drinking and survival. In a univariate analysis, anemia was identified as a significant prognostic factor for 2-year OS (hazard ratio (HR) = 1.897; P = 0.024) and 2-year DFS (HR = 1.776; P = 0.036), independent of tumor, lymph node, metastasis (TNM) stage. In a multivariate analysis, anemia was identified as a highly significant prognostic factor for 2-year OS (HR = 2.125; P = 0.011) and 2-year DFS (HR = 1.898; P = 0.025), independent of TNM stage and initial treatment. We found no statistical difference in the 2-year OS and DFS associated with smoking (P > 0.2) and drinking (P > 0.6) using univariate and multivariate analysis.
CONCLUSIONS
Smoking and drinking were not prognostic for 2-year OS or DFS. Anemia before radiotherapy was associated with poor prognosis and an increased risk of relapse, which may serve as a new prognostic characteristic in ESCC treated with primary radiotherapy. Hemoglobin is a routine examination and anemia is therefore simple and quick to determine.
背景
很少有研究调查贫血、吸烟、饮酒与接受原发性放疗的食管鳞状细胞癌（ESCC）患者生存之间的关系。本研究旨在评估贫血、吸烟和饮酒对接受原发性放疗的 ESCC 患者的预后价值。
方法
本研究纳入了 79 例接受放疗的初治 ESCC 患者。采用 Kaplan-Meier 法和 Cox 比例风险模型分析贫血组和非贫血组、不吸烟者和吸烟者以及不饮酒者和饮酒者之间的 2 年总生存（OS）和无病生存（DFS）。
结果
共纳入 79 例（男 10 例）患者，中位年龄为 63 岁（范围 38-84 岁）。非贫血组的 2 年 OS 和 DFS 分别为 36%和 25%，贫血组分别为 17%和 13%（OS：P=0.019；DFS：P=0.029）。Kaplan-Meier 生存分析显示，吸烟、饮酒与生存之间的 2 年 OS 和 DFS 无统计学差异。单因素分析显示，贫血是 2 年 OS（危险比（HR）=1.897；P=0.024）和 2 年 DFS（HR=1.776；P=0.036）的显著预后因素，与肿瘤、淋巴结、转移（TNM）分期无关。多因素分析显示，贫血是 2 年 OS（HR=2.125；P=0.011）和 2 年 DFS（HR=1.898；P=0.025）的高度显著预后因素，与 TNM 分期和初始治疗无关。单因素和多因素分析均显示，吸烟（P>0.2）和饮酒（P>0.6）与 2 年 OS 和 DFS 无统计学差异。
结论
吸烟和饮酒与 2 年 OS 或 DFS 无关。放疗前贫血与预后不良和复发风险增加相关，这可能成为原发性放疗治疗的 ESCC 的新预后特征。血红蛋白是常规检查，因此贫血的确定简单、快速。
Zotero 插件