老年食管癌患者术后放疗：一项双中心经验。（注：这里原文中的“young-old”表述不太准确，可能是想说“老年”，但按照要求直接翻译了。）

Postoperative radiotherapy for the young-old patients with thoracic esophageal squamous cell carcinoma: A 2-center experience.

作者信息

Ding Wei, Yang Min, Jiang Wanrong, Ge Xiaolin, Sun Xiangdong, Zhou Bin, Liu Feng, Jiang Kai, Shen Fangcheng, Sun Xinchen

机构信息

Department of Radiotherapy, The First Affiliated Hospital of Nanjing Medical University.

Department of Radiotherapy, People's Liberation Army Cancer Center, Jinling Hospital, Nanjing, Jiangsu Province, China.

出版信息

Medicine (Baltimore). 2020 Apr;99(17):e19453. doi: 10.1097/MD.0000000000019453.

DOI:10.1097/MD.0000000000019453

PMID:32332598

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7220665/

Abstract

This study aimed to retrospectively analyze the efficacy and safety of esophagectomy and postoperative radiotherapy (PORT) for patients with thoracic esophageal squamous cell carcinoma (TESCC) in the young-old (aged between 65 and 75 years).The clinical data of 166 young-old patients with esophageal cancer who underwent esophagectomy and PORT from May 2004 to May 2018 in The First Affiliated Hospital of Nanjing Medical University and The PLA Cancer Center, Jinling Hospital were analyzed. The Kaplan-Meier method was used to calculate overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS). The log-rank method was used to test the differences. The Cox regression model was used for the multivariate prognostic analysis.The follow-up rate was 98.5%, and the median follow-up time was 41.2 months. The whole 1-, 3-, and 5-year OS rates were 92.0%, 69.3%, and 58.3%, respectively, and the median OS was 64.7 months (95% CI, 58.3-71.1). The median DFS was 57.9 months (95% CI, 47.4-68.4), and the 1-, 3-, and 5-year DFS rates were 84.8%, 61.5%, and 44.6%, respectively. The median LRFS was 60.8 months (95% CI, 50.5-71.0), and the 1-, 3-, and 5-year LRFS rates were 85.8%, 64.94%, and 53.9%, respectively. The median DMFS was 65.0 months (95% CI, 60.6-69.6), and the 1-, 3-, and 5-year DMFS rates were 91.9%, 77.0%, and 67.5%, respectively. Pathological T staging, lymph node metastasis, pathologic staging, and Karnofsk Performance Status (KPS) were the main factors affecting prognosis. In addition, T staging, lymph node metastasis are also independent prognostic factors. Little severe toxicity was observed.The result indicates that PORT for TESCC patients who can tolerate surgery is safe in the young-old. The efficacy is similar to that of previous patients including younger populations. Pathological T and N stage are major factors that affect prognosis. Concurrent chemotherapy may not improve the survival of the young-old patients undergoing postoperative radiotherapy.

摘要

本研究旨在回顾性分析手术切除联合术后放疗（PORT）治疗老年-老年（年龄在65至75岁之间）胸段食管鳞状细胞癌（TESCC）患者的疗效和安全性。分析了2004年5月至2018年5月在南京医科大学第一附属医院和解放军南京总医院金陵医院接受食管切除术和PORT的166例老年-老年食管癌患者的临床资料。采用Kaplan-Meier法计算总生存期（OS）、无病生存期（DFS）、局部无复发生存期（LRFS）和远处无转移生存期（DMFS）。采用log-rank检验进行差异检验。采用Cox回归模型进行多因素预后分析。随访率为98.5%，中位随访时间为41.2个月。1年、3年和5年的总生存率分别为92.0%、69.3%和58.3%，中位总生存期为64.7个月（95%CI，58.3 - 71.1）。中位无病生存期为57.9个月（95%CI，47.4 - 68.4），1年、3年和5年的无病生存率分别为84.8%、61.5%和44.6%。中位局部无复发生存期为60.8个月（95%CI，50.5 - 71.0），1年、3年和5年的局部无复发生存率分别为85.8%、64.94%和53.9%。中位远处无转移生存期为65.0个月（95%CI，60.6 - 69.6），1年、3年和5年的远处无转移生存率分别为91.9%、77.0%和67.5%。病理T分期、淋巴结转移、病理分期和卡氏功能状态（KPS）是影响预后的主要因素。此外，T分期、淋巴结转移也是独立的预后因素。观察到的严重毒性反应较少。结果表明，对于能够耐受手术的TESCC患者，PORT在老年-老年患者中是安全的。疗效与包括年轻人群在内的既往患者相似。病理T和N分期是影响预后的主要因素。同步化疗可能无法提高接受术后放疗的老年-老年患者的生存率。