Kogo Mari, Suzuki Ayako, Sunaga Tomiko, Kaneko Kazuhiro, Imawari Michio, Kiuchi Yuji
Hepatogastroenterology. 2013 Nov-Dec;60(128):1979-84. doi: 10.5754/hge13131.
BACKGROUND/AIMS: We have retrospectively evaluated clinical data obtained before therapy to enable reliable prediction of recurrence after chemoradiotherapy (CRT) for esophageal cancer.
We analyzed 108 patients who received 5-fluorouracil and platinum combined with 60 Gy radiation. Of the 108 patients, 42 patients with complete response after CRT were selected for this study. The endpoint was recurrence after CRT. Factors significantly related to recurrence were extracted by the multivariate analysis, and a recurrence score was prepared by combining these factors.
The median follow-up interval was 18.5 (2-103) months. Recurrent disease was found in 16 (38.1%) patients. In the univariate analysis, recurrence was associated with nutrition status, family history, dysphagia, location, and length of the tumor. In the multivariate analysis, location of the tumor was selected as a significant factor that contributed independently to recurrence after CRT (p < 0.05). The hazard ratios of the five selected factors was approximated and scored. The cumulative probabilities of tumor recurrence were significantly higher in the high score group than in the low score group (47.5% vs. 12.5% at 6 months, p < 0.01).
The recurrence score is suggested to be an appropriate scoring system with which to predict recurrence in patients with esophageal cancer.
背景/目的：我们回顾性评估了治疗前获得的临床数据，以便能够可靠地预测食管癌放化疗（CRT）后的复发情况。
我们分析了108例接受5-氟尿嘧啶和铂类联合60 Gy放疗的患者。在这108例患者中，选取了42例CRT后完全缓解的患者进行本研究。终点为CRT后的复发情况。通过多因素分析提取与复发显著相关的因素，并将这些因素组合制定复发评分。
中位随访时间为18.5（2 - 103）个月。16例（38.1%）患者出现疾病复发。单因素分析中，复发与营养状况、家族史、吞咽困难、肿瘤位置和长度有关。多因素分析中，肿瘤位置被选为CRT后独立导致复发的显著因素（p < 0.05）。对五个选定因素的风险比进行近似和评分。高分组肿瘤复发的累积概率显著高于低分（6个月时分别为47.5%和12.5%，p < 0.01）。
复发评分被认为是预测食管癌患者复发的合适评分系统。
