Zhang Jie, Bai Han, Zhao Dongmei, Hou Fei, Lu Fei, Xia Yaoxiong, Wang Li
Department of Radiation Therapy, The Third Affiliated Hospital of Kunming Medical University, Yunnan, Kunming, 650000, China.
Department of Radiation Oncology, The Third People's Hospital of Honghe Prefecture, Gejiu, 661021, China.
Sci Rep. 2025 Mar 31;15(1):11017. doi: 10.1038/s41598-025-86655-y.
Esophageal cancer is one of the most prevalent malignancies. This study aimed to examine the impact of factors such as immunotherapy, altitude, radiotherapy target volume, and radiotherapy dose on the prognosis of patients with locally advanced and advanced esophageal cancer who are receiving definitive radiotherapy and living in high-altitude regions. We retrospectively collected data from all patients with locally advanced and advanced esophageal cancer who completed definitive radiotherapy at Yunnan Cancer Hospital between January 2017 and January 2023. A total of 274 patients were included, with a median follow-up time of 24.5 months. The median overall survival (OS) and progression-free survival (PFS) were 15.0 months and 11.0 months, respectively. Adjuvant therapy (including chemotherapy, immunotherapy, and antiangiogenic targeted therapy, P = 0.004) and gross target volume (GTV, P = 0.015) were independent predictors of overall survival, whereas body mass index (BMI, P = 0.037) was an independent predictor of progression-free survival. Patients with a smaller planning target volume (PTV), clinical target volume (CTV), GTV, and gross tumor volume of metastatic regional lymph nodes (GTVnd), as well as those with a smaller New target volume, had a better prognosis. Treatment efficacy affects patient prognosis, with those showing early therapeutic effectiveness having a better prognosis than those for whom the treatment is ineffective. Patients who experienced disease progression within three months after the end of radiotherapy had a poorer prognosis. The altitude and radiotherapy dose had no significant impact on the prognosis of esophageal cancer patients. The location of the lesion, GTV, and simultaneous integrated boost (SIB) radiotherapy were factors influencing the occurrence of esophageal fistulas.
食管癌是最常见的恶性肿瘤之一。本研究旨在探讨免疫治疗、海拔、放疗靶区体积和放疗剂量等因素对在高海拔地区接受根治性放疗的局部晚期和晚期食管癌患者预后的影响。我们回顾性收集了2017年1月至2023年1月期间在云南省肿瘤医院完成根治性放疗的所有局部晚期和晚期食管癌患者的数据。共纳入274例患者，中位随访时间为24.5个月。中位总生存期（OS）和无进展生存期（PFS）分别为15.0个月和11.0个月。辅助治疗（包括化疗、免疫治疗和抗血管生成靶向治疗，P = 0.004）和大体靶区体积（GTV，P = 0.015）是总生存期的独立预测因素，而体重指数（BMI，P = 0.037）是无进展生存期的独立预测因素。计划靶区体积（PTV）、临床靶区体积（CTV）、GTV以及转移区域淋巴结大体肿瘤体积（GTVnd）较小的患者，以及新靶区体积较小的患者，预后较好。治疗疗效影响患者预后，早期显示治疗效果的患者预后优于治疗无效的患者。放疗结束后三个月内出现疾病进展的患者预后较差。海拔和放疗剂量对食管癌患者的预后无显著影响。病变部位、GTV和同步整合加量（SIB）放疗是影响食管瘘发生的因素。
