48例颈段、胸上段食管癌三维适形放疗疗效分析

摘要

Objective:To exPlore the effects and related Prognostic factors of cervical and uPPer - thoracic esoPha-geal carcinoma treated with three - dimensional conformal radiotheraPy(3 - DCRT). Methods:From Jaunary 2006 to APril 2010,48 Patients with cervical and uPPer - thoracic esoPhageal carcinoma treated with 3 - DCRT were retro-sPectively analyzed. The local control rates,survival rates and related Prognostic factors were evaluate with SPSS 13. 0 software. Results:The follow - uP rate was 100% by June 2013. The 1 - ,2 - and 3 - year local control rates were 89. 6% ,70. 8% and 32. 8% ,resPectively. The 1 - ,2 - and 3 - year survival rates were 85. 4% ,60. 4% and 20. 6% ,resPectively. Univariate analysis showed that the significant Prognostic factors were the degree of dysPhagia,T stage,clinical stage,KPS score,short term effect and chemotheraPy. Multivariate analysis revealed that the degree of dysPhagia,clinical stage and chemotheraPy were indePendent Prognostic factors. Conclusion:Three - dimensional conformal radiotheraPy is effective and feasible in the treatment of cervical and uPPer - thoracic esoPhageal cancer. The degree of dysPhagia,clinical stage and chemotheraPy are indePendent Prognostic factors for cervical and uPPer -thoracic esoPhageal cancer.%目的：探讨颈段、胸上段食管癌三维适形放疗（3- DCRT）的治疗效果及其预后的相关因素。方法：回顾性分析2006年1月-2010年4月在本院接受3- DCRT 治疗的48例颈段、胸上段食管癌患者的临床资料，分析局部控制率、生存率及预后的影响因素。结果：随访率为100%，全组1、2、3年局部控制率分别为89.6%、70.8%和32.8%；1、2、3年生存率分别为85.4%、60.4%和20.6%。单因素分析显示，治疗前进食梗阻情况、T 分期、临床分期、KPS 评分、近期疗效、化疗与否与预后有关（P ﹤0.05），而性别、年龄、放疗处方剂量、N 分期与预后无关。Cox 多因素分析显示，治疗前进食梗阻情况、临床分期、化疗与否为独立预后因素（P ﹤0.05）。结论：3- DCRT 治疗颈段、胸上段食管癌安全有效，治疗前进食梗阻轻及临床分期早，三维适形放疗预后越好，反之预后越差，化疗也影响预后。