胸段食管癌术后精确放疗的预后影响因素分析

摘要

目的：探讨胸段食管癌术后精确放疗的预后影响因素，为改善患者的生存质量提供治疗参考。方法选取本院2007年6月至2009年4月收治的633例术后精确放疗的胸段食管癌患者为研究对象，按照患者1、3、5年生存情况进行分组比较，对各组患者临床情况进行单因素分析，并通过Logistic多因素回归分析归纳影响预后的相关因素。结果633例患者均获得有效随访，其中1年生存574例（90.7%），3年生存375例（59.2%），5年生存289例（45.7%），平均生存期为（46.9±8.2）个月；单因素回归分析发现，肿瘤直径、淋巴结转移数量、TNM分期为影响患者预后的单因素（P＜0.05）；多因素回归分析发现，肿瘤直径≥3.0 cm、淋巴结转移数量≥3枚及TNM分期Ⅲ/Ⅳ期是导致胸段食管癌术后精确放疗预后较差的独立影响因素（P＜0.05）。结论胸段食管癌术后精确放疗在改善患者远期生存方面具有一定意义，而具有危险因素的患者预后较差。在今后的临床治疗中，应酌情增加上述患者的淋巴清扫区域和放疗范围，以减少癌细胞转移，改善其生存质量。%ObjectiveTo explore the factors affecting the prognosis of precise radiotherapy of esophageal carcinoma after surgery, provide the measures to improve the life quality of the patients.Method633 cases of patients with thoracic esophageal carcinoma after radical operation and postoperative radiotherapy in our hospital from June 2007 to April 2009 were grouped and compared in accordance with the 1, 3, 5 year survival situation, a single factor analysis of clinical patients in each group, and sums up the factors affecting prognosis by Logistic multi factor regression analysis.Result633 patients were followed up for 1 year, the survival of 574 cases (90.7%), 3 year survival of 375 cases (59.2%), 5 year survival of 289 cases (45.7%), the mean survival time was (46.9±8.2) months; single factor regression analysis showed that, the survival of patients, tumor size, lymph node transfer number, TNM staging were signiifcant statistically (P<0.05); multi factor regression analysis showed that, the tumor diameter≥3 cm, lymph node metastasis and TNM stageⅢ/Ⅳ≥3 period were the results of independent risk factors of poor prognosis in precise radiotherapy of thoracic esophageal carcinoma after operation (P<0.05).ConclusionThoracic esophageal carcinoma after radiotherapy in improving the accuracy of long-term survival in patients with signiifcant, and in patients with risk factors have a poor prognosis, in clinical treatment in the future, as appropriate, to increase the patient's lymph node dissection and radiotherapy range, in order to reduce the metastasis of cancer cells, improve the quality of life.