【摘要】 目的:探讨同期放化疗治疗局部晚期食管癌患者中影响预后的因素。方法:选择我院1996年10月31日～2005年10月31日符合入组条件的食管鳞癌患者共169例,放射治疗剂量60～64Gy,采用常规分割方案,同期化疗采用5-氟尿嘧啶(5-FU)+顺铂(DDP)方案,分别在放疗过程中的第1～2天和第29～30天进行。以无进展生存时间作为主要观察指标,应用COX比例回归风险模型,对患者的临床特征和预后的关系进行单因素和多因素分析。结果:单因素分析结果显示,患者的年龄(P=0.598)、性别(P=0.662)、体质量下降(P=0.456)和肿瘤的病理分级(P=0.833)对无肿瘤进展生存率无明显影响;治疗前的KPS状态评分(P=0.026)、病变长度(P=0.015)、病变部位(P=0.031)、X射线分型(P=0.030)、以CT扫描为基础的临床分期(P=0.004)和近期疗效(P=0.000)对无肿瘤进展生存率有明显影响。多因素分析结果表明,近期疗效(P=0.002)和以CT扫描为基础临床分期(P=0.030)分别为第1、2位独立预后因素。结论:近期疗效和治疗前以CT扫描为基础的临床分期,能够在一定程度上判断进行同期放化疗的食管癌患者的预后。更多还原

【Abstract】 OBJECTIVE:To assess the prognostic factors of patient with local advanced esophageal carcinoma after concurrent chemoradiotherapy.METHODS:One hundred and sixty-nine unresectable esophageal carcinoma patients received concurrent chemoradiotherapy from 31st Oct.1996 to 31st Oct.2005.The radiation dose was 60-64 Gy.All patients received chemotherapy(DDP+5-FU) at d1-d2 and d29-d30 of radiotherapy.Clinical characters were used as analysis for COX regression univarate and multivariate analyses.Progress-free survival(PFS) was the major objective target.RESULTS:Univariate analysis showed that age(P=0.598),gender(P=0.662),weight loss(P=0.456) and pathologic grade(P=0.883) had no effect on PFS.But KPS(P=0.026),length(P=0.015),location(P=0.031),X-ray type(P=0.030),TNM stage based CT scan(P=0.004) and short-term effect(P=0.000) had important effect on PFS.Multivariate analysis showed that short-term effect(P=0.002) and TNM stage based CT scan(P=0.030) were independent prognostic factors.CONCLUSION:Short-term effect and TNM stage based CT may influence the prognosis of patients with esophageal carcinoma treated after concurrent chemoradiotherapy.更多还原