| 沈文斌,高红梅,祝淑钗,李腾,李曙光,李幼梅,刘志坤,李娟,苏景伟,许金蕊.胸上段食管鳞癌根治术后辅助放化疗的疗效分析[J].中华放射医学与防护杂志,2018,38(5):355-359 |
| 胸上段食管鳞癌根治术后辅助放化疗的疗效分析 |
| Efficacy of postoperative chemoradiotherapy after radical resection of squamous cell carcinoma of upper thoracic esophagus |
| 投稿时间：2017-10-23 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.05.006 |
| 中文关键词: 食管肿瘤/食管鳞癌 胸上段 外科治疗 术后放化疗 预后 |
| 英文关键词:Esophageal neoplasms/Esophageal squamous cell carcinoma Upper thoracic region Surgical treatment Postoperative chemoradiotherapy Prognosis |
| 基金项目: |
| 作者 | 单位 | E-mail | | 沈文斌 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 高红梅 | 050011, 石家庄第一医院影像科 | | | 祝淑钗 | 050011 石家庄, 河北医科大学第四医院放疗科 | sczhu1965@163.com | | 李腾 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 李曙光 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 李幼梅 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 刘志坤 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 李娟 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 苏景伟 | 050011 石家庄, 河北医科大学第四医院放疗科 | | | 许金蕊 | 050011 石家庄, 河北医科大学第四医院放疗科 | |
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| 中文摘要: |
| 目的 比较单纯手术与术后放化疗对胸上段食管鳞癌根治术后患者预后的影响。方法 回顾性分析2007年1月至2011年12月在河北医科大学第四医院接受治疗的168例胸上段食管癌患者，根据治疗方法不同分为单纯手术组（86例）和术后放化疗组（82例）。采用SPSS 19.0统计软件进行数据分析，组间资料构成比应用χ2检验，应用Log-rank法检验和单因素预后分析，Cox回归模型行多因素预后分析。结果 全组患者1、3、5年生存率、复发率和远处转移率分别为83.9%、52.4%、43.5%，26.5%、40.8%、43.4%和5.3%、11.4%、16.9%。多因素分析结果显示，患者性别、T分期、N分期和治疗方式为患者独立性预后影响因素（P=0.020、0.008、0.005、0.000）；N分期和治疗方式为局部/区域复发的独立性预后影响因素（P=0.001、0.003）；分化程度和T分期为远处转移的独立性预后影响因素（P=0.045、0.020）。单纯手术组和术后放化疗（POCRT）组患者胸腔内-区域复发率分别为44.2%（38/86）和29.3%（24/82），差异有统计学意义（χ2=7.110，P<0.05）；远处转移率分别为19.8%（17/86）和13.4%（11/82），差异无统计学意义（P>0.05）。结论 胸上段食管鳞癌根治术后患者仍有较高的复发率，术后放化疗可以提高患者的总生存率，并降低患者的复发率，但能否降低患者的远处转移率有待进一步研究。 |
| 英文摘要: |
| Objective To compare the prognosis of patients with squamous cell carcinoma of the upper thoracic esophagus after radical resection with and without postoperative chemoradiotherapy (POCRT). Methods From January 2007 to December 2011, 168 patients with upper thoracic esophageal carcinoma who were treated in the Fourth Hospital of Hebei Medical University were retrospectively included in this study. According to the different treatment method, they were divided into simple surgery group (86 cases) and POCRT group (82 cases) respectively. Based on SPSS statistical software, the group data composition, prognostic analysis and multivariate prognostic analysis were performed by χ2 test, Log-rank method and Cox regression model, respectively. Results The 1, 3, 5 year-survival rate, recurrence rate and distant metastasis rate were 83.9%, 52.4%, 43.5%, 26.5%, 40.8%, 43.4% and 5.3%, 11.4%, 16.9%, respectively. The result of multivariate analysis showed that gender, T stage, N stage and treatment method were independent prognostic factors of overall survival (P=0.020, 0.008, 0.005, 0.000); N staging and treatment method were the independent prognostic factors of local/regional recurrence (P=0.001, 0.003); differentiation and T staging were the independent prognostic factors of distant metastasis (P=0.045, 0.020). The intrathoracic regional recurrence rate of operation only group and POCRT group patients were 44.2% (38/86) and 29.3% (24/82) respectively, where the difference was statistically significant (χ2=7.110, P<0.05). The rate of metastasis were 19.8% (17/86) and 13.4% (11/82) respectively without significant difference (P>0.05). Conclusions The recurrence rate of patients with upper thoracic esophageal squamous cell carcinoma after radical resection was still high. Postoperative chemoradiotherapy can improve the overall survival rate and reduce the recurrence rate, but whether it can reduce the patient's distant metastasis rate needs further study. |
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