CAJ | 학술논문

目的探讨食管癌根治术后局部复发患者的放射治疗疗效和预后影响因素.方法回顾性分析食管癌根治术后局部区域复发行放射治疗93例患者的临床特点,结合随访资料进行预后因素分析,用Kaplan-Meier法和Logrank法分析比较生存率,用Cox模型进行多因素回归分析.结果全组患者中位生存时间11.0个月(95%CI 9.4～12.6个月),1、2、3年累积生存率分别为40.9%、10.1%和6.7%.单因素分析显示:患者年龄、PS评分、是否放化疗联合治疗、放射治疗剂量与预后相关;原发灶部位、术后复发间隔时间、以及转移灶数目均不影响预后.Cox模型多因素回归分析显示仅是否放化疗联合治疗、放射治疗剂量为独立预后因素.结论食管癌根治术后复发放射治疗可以使部分患者生存时间延长,积极放化疗联合治疗、放射治疗剂量≥60 Gy者预后好.
목적 탐토식관암근치술후국부복발환자적방사치료료효화예후영향인소.방법 회고성분석식관암근치술후국부구역복발행방사치료93례환자적림상특점,결합수방자료진행예후인소분석,용Kaplan-Meier법화Logrank법분석비교생존솔,용Cox모형진행다인소회귀분석.결과 전조환자중위생존시간11.0개월(95%CI 9.4～12.6개월),1、2、3년루적생존솔분별위40.9%、10.1%화6.7%.단인소분석현시:환자년령、PS평분、시부방화료연합치료、방사치료제량여예후상관;원발조부위、술후복발간격시간、이급전이조수목균불영향예후.Cox모형다인소회귀분석현시부시부방화료연합치료、방사치료제량위독립예후인소.결론 식관암근치술후복발방사치료가이사부분환자생존시간연장,적겁방화료연합치료、방사치료제량≥60 Gy자예후호.
Objective To evaluate the outcome of radiotherapy for recurrent esophageal cancer after surgery and to determine the prognostic factors. Methods From Jan 2004 to Dec 2009, 93 patients of esophageal carcinoma with loco-regional recurrence as the first site of failure after surgery were retrospectively reviewed. Kaplan-Meier method was used to analyze the survival. Logrank test was used to evaluate the difference between the groups. Multivariate survival analysis was conducted using a Cox proportional hazard regression model with a backward stepwise procedure. Results The overall survival rates at 1, 2 and 3 years were 40. 9% , 10. 1% and 6. 7% ,respectively,but with a median survival time of 11.0 months(95% CI 9. 4-12. 6) . In univariate analysis, age,PS, radiation dose and retreatment methods were independent prognostic factors. In multivariate analysis, only radiation dose and retreatment methods were independent prognostic factors for overall survival. Conclusions The prognosis of patients with postoperative loco-regional recurrence of esophageal cancer is poor. However, a long-term survival maybe expected by definitive chemoradiotherapy.