影响老年食管癌患者放疗后长期生存的因素。
Factors affecting long-term survival in elderly patients undergoing radiotherapy for esophageal carcinoma.
作者信息
Lu Xiaoxu, Wu Hui, Wang Jianhua, Chen Yongshun, Xu Jing
机构信息
Department of Radiotherapy, The Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan 450008, P.R. China.
出版信息
Mol Clin Oncol. 2014 Jul;2(4):571-574. doi: 10.3892/mco.2014.285. Epub 2014 Apr 30.
This study was conducted with the aim to analyze the factors affecting the 1-, 3- and 5-year survival rate of elderly patients with esophageal carcinoma. Between 2004 and 2008, a total of 371 patients aged ≥70 years treated with radiotherapy alone were enrolled in this study. The clinical characteristics and radiotherapy dose were evaluated by survival rate and the 1-, 3- and 5-year overall survival (OS) rates were found to be 42, 13.2 and 9.16%, respectively. The univariate analysis revealed significant differences in T, N, M and clinical stage and radiotherapy dose (all P-values <0.05) and no significant differences in gender (all P-values >0.05). There was a difference in tumor location when only comparing the 3- and 5-year OS rates (P=0.031 and P=0.025, respectively). The multivariate analysis identified clinical stage as an independent factor for the 1-year OS rate (P=0.003), whereas radiotherapy dose and clinical stage were found to be independent factors for the 3- and 5-year OS rates (all P-values 0.05). In the analysis of radiotherapy dose, we observed no significant difference in the 1-year OS rate between the radiation dose (DT) >60 Gy and the 50 Gy≤DT<60 Gy groups (P=0.363); however, there were statistically significant differences in the 3-year OS rate between the 50 Gy≤DT<60 Gy and the other groups (P=0.039 and P=0.032); there were no significant differences in the 5-year OS rate among the dose groups (all P-values >0.05). In conclusion, according to the findings of this retrospective study, radiotherapy alone for elderly patients with esophageal cancer does not appear to be acceptable and there is a need for a more effective treatment. T, N, M and clinical stage and radiotherapy dose were identified as factors significantly affecting the 1-, 3- and 5-year OS in elderly patients with esophageal carcinoma, although a higher radiotherapy dose with normal fractionation did not appear to improve the OS rate.
本研究旨在分析影响老年食管癌患者1年、3年和5年生存率的因素。2004年至2008年期间，本研究共纳入371例年龄≥70岁且仅接受放疗的患者。通过生存率评估临床特征和放疗剂量，发现1年、3年和5年总生存率（OS）分别为42%、13.2%和9.16%。单因素分析显示，T、N、M、临床分期和放疗剂量存在显著差异（所有P值<0.05），而性别无显著差异（所有P值>0.05）。仅比较3年和5年OS率时，肿瘤位置存在差异（分别为P = 0.031和P = 0.025）。多因素分析确定临床分期是1年OS率的独立因素（P = 0.003），而放疗剂量和临床分期是3年和5年OS率的独立因素（所有P值<0.05）。在放疗剂量分析中，我们观察到放射剂量（DT）>60 Gy组与50 Gy≤DT<60 Gy组之间1年OS率无显著差异（P = 0.363）；然而，50 Gy≤DT<60 Gy组与其他组之间3年OS率存在统计学显著差异（P = 0.039和P = 0.032）；各剂量组之间5年OS率无显著差异（所有P值>0.05）。总之，根据这项回顾性研究的结果，老年食管癌患者仅接受放疗似乎不可接受，需要更有效的治疗方法。T、N、M、临床分期和放疗剂量被确定为显著影响老年食管癌患者1年、3年和5年OS的因素，尽管常规分割的较高放疗剂量似乎并未提高OS率。
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