| 白文文,周志国,甄婵军,等.159例颈及胸上段食管癌调强放疗长期疗效[J].中华放射医学与防护杂志,2016,36(1):28-34.Bai Wenwen,Zhou Zhiguo,Zhen Chanjun,et al.Long-term efficacy of 159 cases of cervical and upper esophageal carcinoma treated with intensity-modulated radiotherapy[J].Chin J Radiol Med Prot,2016,36(1):28-34 |
| 159例颈及胸上段食管癌调强放疗长期疗效 |
| Long-term efficacy of 159 cases of cervical and upper esophageal carcinoma treated with intensity-modulated radiotherapy |
| 投稿时间：2015-07-21 |
| DOI：10.3760/cma.j.issn.0254-5098.2016.01.005 |
| 中文关键词: 食管癌 放射治疗 调强放疗 预后 |
| 英文关键词:Esophageal carcinoma Radiotherapy Intensity-modulated radiation therapy (IMRT) Prognosis |
| 基金项目:国家自然科学基金(81301298,81271699,81301936,81472811);中国博士后科学基金(2015M571647);山东省自然科学基金(ZR2013HL044) |
|
| 摘要点击次数: 4414 |
| 全文下载次数: 2601 |
| 中文摘要: |
| 目的 观察颈及胸上段食管癌患者调强放疗(IMRT)的长期疗效,并对其相关预后因素进行分析。方法 回顾性分析2006年1月-2012年8月收治的符合入组标准的159例接受IMRT的颈及胸上段食管鳞癌患者,观察其急性不良反应、治疗失败方式及1、3、5年局部控制率和生存率,并分析相关预后因素。结果 随访率99.4%,随访时间满1、3、5年者分别为159、150、57例。近期总有效率为95.6%。全组1、3、5年局部控制率分别为72.3%、56.6%、52.1%,1、3、5年生存率分别为82.4%、47.0%、34.8%,中位生存期31个月。其中颈段食管癌1、3、5年局部控制率和生存率分别为85.4%、62.5%、53.7%和83.3%、55.4%、33.3%,胸上段1、3、5年局部控制率和生存率分别为68.6%、55.2%、52.2%和81.3%、44.6%、35.7%,颈段与胸上段食管癌的局部控制和生存比较,差异无统计学意义(P>0.05)。全组单因素和多因素分析均显示,肿瘤靶区体积(GTV)和近期疗效为影响生存的因素(χ2=19.407、35.489,P<0.05)。全组1、2级急性放射性肺炎的发生率分别为13.2%、5.7%,1、2、3级急性放射性食管炎的发生率分别为54.7%、8.8%、3.3%。肿瘤局部未控和复发占总治疗失败的61.1%。结论 颈及胸上段食管癌IMRT的长期疗效较佳,不良反应较轻,GTV及近期疗效是影响生存的独立预后因素。肿瘤局部未控和复发仍为治疗失败的主要原因。 |
| 英文摘要: |
| Objective To evaluate the long-term efficacy and related prognostic factors of cervical and upper esophageal carcinoma treated with intensity-modulated radiotherapy (IMRT). MethodsFrom January 2006 to August 2012, 159 patients of cervical and upper esophageal squamous cell carcinoma treated with IMRT were analyzed retrospectively. The acute side effect and failure modes of treatment were observed, and l-, 3- and 5-year local control rates, survival rates, and prognostic factors were analyzed. Results The follow-up rate of patients was 99.4%. The number of patients who completed the 1-, 3- and 5-year follow-up were 159, 150 and 57, respectively. The overall remission rate was 95.6%. The 1-, 3- and 5-year local control rates were 72.3%, 56.6% and 52.1%, respectively. The 1-, 3- and 5-year survival rates were 82.4%, 47.0% and 34.8%, respectively. The median survival time was 31 months. The 1-, 3- and 5-year local control rates and survival rates were 85.4%, 62.5%, 53.7% and 83.3%, 55.4%, 33.3% for cervical esophageal carcinoma, 68.6%, 55.2%, 52.2% and 81.3%, 44.6%, 35.7% for upper esophageal carcinoma. There were no significant differences in the local control rates and overall survival rates between the cervical esophageal carcinoma and upper esophageal carcinoma groups (P>0.05). Both univariate analysis and multivariate analysis showed that gross tumor volume (GTV) and short term effect were the prognostic factors (χ2=19.407, 35.489, P<0.05). Grade 1 and 2 acute pneumonitis incidence rates were 13.2% and 5.7%, respectively. Grade 1, 2 and 3 acute esophagitis incidence rates were 54.7%, 8.8% and 3.3%, respectively. The local failure accounted for 61.1% of all treatment-related failures. Conclusions IMRT is safe and effective in the treatment of cervical and upper esophageal carcinoma. The GTV size and tumor response after radiotherapy are independent prognostic factors for survival. Local failure is still the main reason of treatment failures. |
| HTML 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|