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脑放疗能否提高脑转移食管鳞癌患者的生存率?

Does brain radiotherapy improve survival in patients with esophageal squamous cell carcinoma with brain metastasis?

机构信息

Department of Medical Oncology, Fujian Provincial Hospital, Provincial Clinical College, Fujian Medical University, Fuzhou 350000, China.

Department of Radiation Oncology, Joint Logistics 900 Hospital, Fujian Medical University, Fuzhou 350000, China.

出版信息

Ann Palliat Med. 2020 May;9(3):637-643. doi: 10.21037/apm.2020.04.23. Epub 2020 Apr 20.

Abstract

BACKGROUND

To investigate the clinical characteristics, influencing factors, and their impact on survival in patients with brain metastases from esophageal squamous cell carcinoma (BM-ESCC).

METHODS

A total of 67 patients with patients with newly diagnosed BM-ESCC were retrospectively analyzed from December 2000 to December 2016, in order to examine the correlation between clinicopathological characteristics and brain metastases, and between brain metastases and survival.

RESULTS

The number of BM-ESCC was positively correlated with T and N stages (P<0.05). The higher the T and N stages, the higher the incidence. The median survival time was 9.65 months. N stage was an independent risk factor for BM-ESCC. N0 + N1 was associated with a lower risk of brain metastases (P<0.05). Patients with 1 brain metastasis had a significantly longer survival than those with 2 and 3 brain metastases. N stage-stratified analysis revealed that N0 + N1 patients had a longer survival than N2 and N3 patients (P<0.05). Cox regression analysis revealed that mortality in T3 + T4 patients was 2.337 times that of Tis + T1 patients; mortality in N3 patients was 3.486 times that of N0 + N1 patients; and mortality in untreated patients was 2.772 times that of those treated with whole brain radiotherapy.

CONCLUSIONS

The number of BM-ESCC is correlated to T and N stages. The higher the N stage, the higher risk of brain metastases. The higher of T and N stages in ESCC, the worse in prognosis. Whole brain radiotherapy could offer greater survival benefits.

摘要

背景

探讨食管鳞癌脑转移(BM-ESCC)患者的临床特征、影响因素及其对生存的影响。

方法

回顾性分析 2000 年 12 月至 2016 年 12 月期间新诊断为 BM-ESCC 的 67 例患者,以检验临床病理特征与脑转移之间的相关性,以及脑转移与生存之间的相关性。

结果

BM-ESCC 的数量与 T 分期和 N 分期呈正相关(P<0.05)。T 分期和 N 分期越高,发生率越高。中位生存时间为 9.65 个月。N 分期是 BM-ESCC 的独立危险因素。N0+N1 与脑转移风险较低相关(P<0.05)。单发脑转移患者的生存时间显著长于多发脑转移患者。N 分期分层分析显示,N0+N1 患者的生存时间长于 N2 和 N3 患者(P<0.05)。Cox 回归分析显示,T3+T4 患者的死亡率是Tis+T1 患者的 2.337 倍;N3 患者的死亡率是 N0+N1 患者的 3.486 倍;未治疗患者的死亡率是接受全脑放疗患者的 2.772 倍。

结论

BM-ESCC 的数量与 T 分期和 N 分期相关。N 分期越高,脑转移风险越高。ESCC 的 T 分期和 N 分期越高,预后越差。全脑放疗可带来更大的生存获益。

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