【摘要】 目的:分析影响老年食管癌患者放射治疗长期生存的多种因素。方法:回顾性分析351例进行放射治疗的老年食管鳞癌患者的生存情况,并采用Kaplan-Meier法计算生存率,Log-rank法检验单因素分析及Cox回归模型进行多因素分析。结果:截止至2013-01-10,总随访率90.9%,1、3和5年总生存率分别为44.2%(155/351)、13.96%(49/351)和9.69%(34/351)。单因素分析结果显示,1、3和5年生存率在T分期、N分期、M分期和临床分期等方面差异有统计学意义,而化疗在3和5年生存率中差异有统计学意义。多因素预后分析结果示,N分期、M分期和放疗剂量为影响1年生存率的独立因素,临床分期为影响3和5年生存率的独立因素。1年生存率中,放疗剂量2组(56.9%)明显优于1组(41.3%)和3组(35.3%),差异有统计学意义,χ2=20.678,P<0.001;3年生存率中,3组(5.88%)与1组(17.52%)和2组(17.46%)比较,差异有统计学意义,χ2=11.503,P=0.009。随访结束共死亡317例,其中肿瘤因素258例(81.4%),放疗并发症33例(10.4%),心脑血管疾病14例(4.42%),其他12例(3.79%)。结论:T、N、M、临床分期、放疗剂量及是否化疗为影响老年食管癌患者长期生存率的主要因素,配合全身化疗能够延长生存期,而超过60Gy的放疗剂量对于老年食管鳞癌患者无益。更多还原

【Abstract】 OBJECTIVE:To analyze the factors to influence the 1-,3-,5-year survival rate of elderly patients with esophageal carcinoma.METHODS:The long-term survival of 351 elderly patients with esophageal carcinoma treated by radiotherapy was analyzed retrospectively,and also calculated by Kaplan-Meier method.Logrank method was used for univariate analysis and Cox regression model was used for multivariate analyses.RESULTS:Till Jan.10,2013,the overall follow-up rate was 90.9%,and the 1-year,3-year and 5-year overall survival rates were 44.2%,13.96%and 9.69%respectively.There were significant differences on the prognosis of T stage,N stage,M stage,clinical stage.The results of multivariate prognosis analysis showed that N stage,M stage,and radiotherapy dose were independent factors in the 1-year survival rate;clinical stage were independent factors in the 3-year and 5-year survival rate.In the analysis of the dose of 60Gy in the 1-year survival rate was better significantly than more than 60Gy and equal or more than 50Gy but less than that of 60Gy(χ2=20.678,P<0.001).In the 3-year survival rate,the differences were statistical significance among the dose of equal or more than that of 50Gy but less than that of 60Gy,of more than that of 60Gy and of equal that of 60Gy(χ2=11.503,P=0.009).317patients died at the end of the follow-up,258(81.4%)patients died from to primary tumor, 33(10.4%)patients died from radiotherapy complications;14(4.42%)patients died from underlying disease.and 12(3.79%)patients died to unknown reasons and unexpected deaths.CONCLUSINOS:T-staging,N-staging,M-staging, clinical staging,radiotherapy dose and chemotherapy are important factors to influence long-term survival rate.The addition of concurrent radiochemotherapy can improve long-term survival.More than 60Gy dose of the radiation therapy for the elderly esophageal squamous cell carcinoma patients is useless.更多还原