中华放射医学与防护杂志

钟胜,吴清泉,王万伟,等.Ⅱ/Ⅲ期食管癌术前放化疗的影像学评价对预后的影响[J].中华放射医学与防护杂志,2015,35(4):270-273.Zhong Sheng,Wu Qingquan,Wang Wanwei,et al.Predictive value of imaging evaluation in stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy[J].Chin J Radiol Med Prot,2015,35(4):270-273

Ⅱ/Ⅲ期食管癌术前放化疗的影像学评价对预后的影响

Predictive value of imaging evaluation in stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy

投稿时间：2014-08-06

DOI：10.3760/cma.j.issn.0254-5098.2015.04.008

中文关键词: 食管癌术前放化疗完全缓解影像学预后

英文关键词:Esophageal carcinoma Preoperative chemoradiotherapy Complete response Imaging Prognosis

基金项目:

作者	单位	E-mail
钟胜	223300 淮安, 南京医科大学附属淮安第一医院胸外科
吴清泉	223300 淮安, 南京医科大学附属淮安第一医院胸外科
王万伟	223300 淮安, 南京医科大学附属淮安第一医院放疗科
陶光州	223300 淮安, 南京医科大学附属淮安第一医院放疗科
彭进	223300 淮安, 南京医科大学附属淮安第一医院放疗科
朱卫国	223300 淮安, 南京医科大学附属淮安第一医院放疗科	jshazwg@126.com

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中文摘要:

目的回顾性分析Ⅱ/Ⅲ期食管癌术前放化疗后影像学评价对预后的影响.方法对有完整随访资料的145例Ⅱ/Ⅲ期食管癌术前放化疗患者进行回顾性分析.分析内容包括术后病理完全缓解(pCR)与未达完全缓解(NpCR)、X射线造影完全缓解(xCR)与未完全缓解(NxCR)及实体瘤疗效评价标准(RECIST)完全缓解(rCR)与未完全缓解(NrCR)的总生存率,并进行多因素分析.结果全部145例患者,pCR率33.8%,xCR率42.8%,rCR率38.6%.pCR患者与NpCR患者1、3、5年总生存率分别为87.8%、79.6%、61.2%与75%、40.6%、24.0%,差异有统计学意义(χ²=20.215,P<0.05);xCR患者与NxCR患者1、3、5年总生存率分别为80.6%、66.1%、51.6%与75%、44.6%、25.3%,差异有统计学意义(χ²=8.895,P<0.05);rCR患者与NrCR患者1、3、5年总生存率分别为83.9%、69.6%、53.6%与76.4%、46.1%、25.8%,差异有统计学意义(χ²=10.862,P<0.05),Cox模型进行多因素分析显示pCR是独立预后因素(HR=0.333,95%CI:0.200~0.554,P<0.05).结论 xCR、rCR较NxCR、NrCR明显提高了生存率,可以指导临床进行疗效判断;pCR为独立预后因素,术后pCR依然是食管癌术前同步放化疗疗效判断的金标准.

英文摘要:

Objective Retrospectively analyzed the predictive value of imaging evaluation in stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy. Methods A total of 145 stage Ⅱ/Ⅲ esophageal carcinoma pantients were enrolled. We analyzed the overall survival rates of the patients with pathological complete response (pCR) and those without (NpCR), X-film complete response (xCR) and those without (NxCR), RECIST complete response (rCR) and those without (NrCR). And we used Cox model for multivariate analysis. Results The rates of pCR, xCR and rCR were 33.8%, 42.8% and 38.6% for all patients, respectively. The 1-,3- 5-year overall survival rates were 87.8%, 79.6%, 61.2% for pCR patients and 75%, 40.6%, 24.0% for NpCR patients(χ²=20.215,P<0.05), respectively; The 1-,3- 5-year overall survival rates were 80.6%, 66.1%, 51.6% for xCR patients and 75%, 44.6%, 25.3% for NxCR patients(χ²=8.895,P<0.05), respectively; The 1-,3- 5-year overall survival rates were 83.9%, 69.6%, 53.6% for rCR patients and 76.4%, 46.1%, 25.8% for NxCR patients(χ²=10.862,P<0.05), respectively. Multivariate survival analysis using Cox regression model showed that pCR was a positive independent prognostic factor (HR=0.333, 95%CI:0.200-0.554, P<0.05). Conclusions Short-term imaging evaluation could effectively predict the prognosis of stageⅡ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy. And pCR was a positive independent prognostic factor.

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