【摘要】 目的研究老年食管癌患者的治疗耐受性、放疗疗效及影响预后因素。方法 92例年龄≥75岁Ⅰ~Ⅳ期的食管癌患者作为老年组,按照相对应的治疗时间、性别、肿瘤部位相匹配的标准,按1:1的比例选取92例50~70岁食管癌高发患者作为对照组;两组患者接受同期化疗、放疗。对比分析两组患者的临床指标及1、3和5年生存情况,并分析其预后影响因素。结果两组患者的性别构成、肿瘤部位比较差异无统计学意义(P>0.05)。两组的病变长度、合并慢性病(心肺)情况比较差异具有统计学意义(P<0.05)。两组患者接受同期化疗例数和放疗剂量比较差异具有统计学意义(P<0.05),组间放疗技术比较差异无统计学意义(P>0.05)。老年组和对照组的中位生存期分别为11个月、21个月,老年组1、3和5年生存率分别为47.8%(44/92)、10.9%(10/92)、2.2%(2/92),对照组1、3和5年生存率分别为65.2%(60/92)、26.1%(24/92)、14.1%(13/92),两组患者的中位生存期比较,差异具有统计学意义(P<0.01)。老年组的生存率低于对照组,差异具有统计学意义(P=0.001<0.01)。如剔除放射剂量不足50 Gy和远处转移病例,老年组的生存率低于对照组,但差异无统计学意义(P=0.094>0.05)。利用单因素分析法可能影响预后的因素显示:影响老年组的生存因素为放疗剂量、合并远处转移和放疗结束时近期疗效;影响对照组的生存因素为肿瘤部位和放疗结束时近期疗效。结论老年食管癌患者的总生存率要低于年轻者,耐受性也较差;但接受50~60 Gy剂量放疗可能获得好的疗效和生存。更多还原

【Abstract】 Objective To research treatment tolerance, curative effect by radiotherapy and influencing factor for prognosis in senile esophageal tumor patients. Methods There were 92 stage Ⅰ ~ Ⅳ esophageal tumor patients aging ≥ 75 years old as senile group. Other 92 esophageal tumor patients aging 50~70 years old under 1:1 ratio with matched treatment time, gender and tumor location were taken as control group. Both groups received concurrent chemotherapy and radiotherapy. Comparative analysis was made on clinical indexes and 1-year, 3-year and 5-year survival between the two groups. Influencing factors on their prognosis were analyzed. Results There was no statistically significant difference of gender composition and tumor location between the two groups(P>0.05). The difference of lesion length and complicated chronic disease(heart and lung) condition between the two groups had statistical significance(P<0.05). The difference of cases receiving concurrent chemotherapy and radiotherapy and radiotherapy dosage between the two groups had statistical significance(P<0.05), while their difference of radiotherapy technique had no statistical significance(P>0.05). The senile group and the control group had median survival time respectively as 11 months and 21 months. The senile group had 1-year, 3-year and 5-year survival rate respectively as 47.8%(44/92), 10.9%(10/92) and 2.2%(2/92). The control group had 1-year, 3-year and 5-year survival rate respectively as 65.2%(60/92), 26.1%(24/92) and 14.1%(13/92). The difference of median survival time between the two groups had statistical significance(P<0.01). The senile group had lower survival rate than the control group, and the difference had statistical significance(P=0.001<0.01). With exception of cases with radiation dose <50 Gy and distant metastasis, the senile group still had lower survival rate than the control group, while their difference had no statistical significance(P=0.094>0.05). Univariate analysis showed radiotherapy dosage, complicated distant metastasis and short-term curative effect after radiotherapy as influencing factors for survival in the senile group; tumor location and short-term curative effect after radiotherapy as influencing factors for survival in the control group. Conclusion Senile esophageal tumor patients have lower total survival rate and worse tolerance than younger patients, however, implement of 50~60 Gy as radiotherapy dosage can provide excellent curative effect and survival.更多还原