Department of Radiation Oncology, The First Affiliated Hospital of Nanjing Medical University, 300, Guangzhou Road, Gulou District, Nanjing, Jiangsu, China.
Department of Radiation Oncology, Nanjing Jiangning Hospital and the Affiliated Jiangning Hospital of Nanjing Medical University, 168, Gushan Road, Jiangning District, Nanjing, Jiangsu, China.
Cancer Radiother. 2022 Nov;26(8):1002-1007. doi: 10.1016/j.canrad.2022.01.008. Epub 2022 Aug 4.
Chemoradiotherapy is regarded as a standard scheme for inoperable and unresectable esophageal cancers. Our aims were to explore the prognostic factors relevant to esophageal squamous cell carcinoma (ESCC) following intensity-modulated radiation therapy (IMRT) plus chemotherapy.
Totally 495 ESCC patients undergoing IMRT combined with chemotherapy in our hospital between 2011 and 2020 were retrospectively analyzed. Potential clinical prognosis-related factors were assessed by uni- and multivariate analyses.
The median overall survival (OS) and progression-free survival (PFS) of the ESCC patients were 2.25 and 1.24years, respectively. Uni- and multivariate analyses demonstrated the relevant independent prognostic factors of OS and PFS were gender, T stage, N stage, clinical stage, and tumor location (P<0.05), but not chemotherapy or radiotherapy dose. We further compared the 5-year OS rates among different T stages, N stages, clinical stages, genders, and tumor locations. The survival rate at the higher clinical stage was significantly lower (P<0.001). The 5-year OS in the upper thorax of the tumor was 46.0% and exceeded other tumor locations (P<0.05). The 5-year OS was 56.1% among females and 33.3% among males (P=0.001).
For ESCC patients receiving IMRT combined with chemotherapy, their long-term curative effects are influenced by T stages, N stages, clinical stages, genders, and tumor locations. ESCC patients who are females, or have upper thoracic tumor, or are at early clinical stage own better prognosis.
放化疗被认为是不可切除和不可切除食管癌的标准治疗方案。我们的目的是探讨调强放疗（IMRT）联合化疗后与食管鳞状细胞癌（ESCC）相关的预后因素。
回顾性分析了 2011 年至 2020 年期间在我院接受 IMRT 联合化疗的 495 例 ESCC 患者。通过单因素和多因素分析评估潜在的临床预后相关因素。
ESCC 患者的中位总生存期（OS）和无进展生存期（PFS）分别为 2.25 年和 1.24 年。单因素和多因素分析表明，OS 和 PFS 的相关独立预后因素是性别、T 分期、N 分期、临床分期和肿瘤位置（P<0.05），而不是化疗或放疗剂量。我们进一步比较了不同 T 分期、N 分期、临床分期、性别和肿瘤位置的 5 年 OS 率。较高临床分期的生存率明显较低（P<0.001）。肿瘤上胸的 5 年 OS 率为 46.0%，超过其他肿瘤部位（P<0.05）。女性的 5 年 OS 率为 56.1%，男性为 33.3%（P=0.001）。
对于接受 IMRT 联合化疗的 ESCC 患者，其长期疗效受 T 分期、N 分期、临床分期、性别和肿瘤位置的影响。女性、上胸肿瘤或早期临床分期的 ESCC 患者预后较好。
