中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2012年
3期
217-221
,共5页
王奇峰%章文成%肖泽芬%张红星%陈东福%冯勤付%周宗玫%吕纪马%梁军%王绿化%殷蔚伯
王奇峰%章文成%肖澤芬%張紅星%陳東福%馮勤付%週宗玫%呂紀馬%樑軍%王綠化%慇蔚伯
왕기봉%장문성%초택분%장홍성%진동복%풍근부%주종매%려기마%량군%왕녹화%은위백
食管肿瘤/术前放射疗法%改良第七版国际抗癌联盟分期%预测预后
食管腫瘤/術前放射療法%改良第七版國際抗癌聯盟分期%預測預後
식관종류/술전방사요법%개량제칠판국제항암련맹분기%예측예후
Esophageal neoplasms/preoperative radiotherapy%Modified international union against cancer stage%Prediction prognosis
目的 评价食管癌术前放疗后病理T、N分期以及国际抗癌联盟(UICC) TNM分期是否能准确预测预后.方法 回顾分析1980-2007年本院接受术前放疗并有详细临床、病理、放疗和手术记录的311例食管鳞状细胞癌患者资料.Kaplan-Meier法生存分析并Logrank检验和单因素分析.结果 随访率96.5％,随访时间满5、10年者分别为89、43例.全组单因素分析发现放疗后原发部位有无肿瘤残存(T-pCR,x2=11.53,P=0.001)和淋巴结转移个数(0、1～3、≥4个,x2=42.13,P=0.000)是影响预后因素.UICC第7版分期可用于区分上述患者预后.而根据转移淋巴结数改良第7版N分期为N0(0个)、N1(1～3个)、N2(≥4个)期并结合残存癌T分期,则ypⅠ期(T1-2N0M0期)与ypⅡ期(T0-3N1 M0期+T3N0M0期)、ypⅡ期与ypⅢ期(T4N0-1 M0期或T0-3N2 M0期)间预后差异均有 统计学意义(x2=11.15、23.39,P =0.001、0.000).结论 食管鳞状细胞癌术前放疗后病理的T分期和阳性淋巴结个数是影响预后因素.UICC第7版分期能较准确评价预后,改良第7版N分期后与T分期结合更方便、准确预测顶后.
目的 評價食管癌術前放療後病理T、N分期以及國際抗癌聯盟(UICC) TNM分期是否能準確預測預後.方法 迴顧分析1980-2007年本院接受術前放療併有詳細臨床、病理、放療和手術記錄的311例食管鱗狀細胞癌患者資料.Kaplan-Meier法生存分析併Logrank檢驗和單因素分析.結果 隨訪率96.5％,隨訪時間滿5、10年者分彆為89、43例.全組單因素分析髮現放療後原髮部位有無腫瘤殘存(T-pCR,x2=11.53,P=0.001)和淋巴結轉移箇數(0、1～3、≥4箇,x2=42.13,P=0.000)是影響預後因素.UICC第7版分期可用于區分上述患者預後.而根據轉移淋巴結數改良第7版N分期為N0(0箇)、N1(1～3箇)、N2(≥4箇)期併結閤殘存癌T分期,則ypⅠ期(T1-2N0M0期)與ypⅡ期(T0-3N1 M0期+T3N0M0期)、ypⅡ期與ypⅢ期(T4N0-1 M0期或T0-3N2 M0期)間預後差異均有 統計學意義(x2=11.15、23.39,P =0.001、0.000).結論 食管鱗狀細胞癌術前放療後病理的T分期和暘性淋巴結箇數是影響預後因素.UICC第7版分期能較準確評價預後,改良第7版N分期後與T分期結閤更方便、準確預測頂後.
목적 평개식관암술전방료후병리T、N분기이급국제항암련맹(UICC) TNM분기시부능준학예측예후.방법 회고분석1980-2007년본원접수술전방료병유상세림상、병리、방료화수술기록적311례식관린상세포암환자자료.Kaplan-Meier법생존분석병Logrank검험화단인소분석.결과 수방솔96.5％,수방시간만5、10년자분별위89、43례.전조단인소분석발현방료후원발부위유무종류잔존(T-pCR,x2=11.53,P=0.001)화림파결전이개수(0、1～3、≥4개,x2=42.13,P=0.000)시영향예후인소.UICC제7판분기가용우구분상술환자예후.이근거전이림파결수개량제7판N분기위N0(0개)、N1(1～3개)、N2(≥4개)기병결합잔존암T분기,칙ypⅠ기(T1-2N0M0기)여ypⅡ기(T0-3N1 M0기+T3N0M0기)、ypⅡ기여ypⅢ기(T4N0-1 M0기혹T0-3N2 M0기)간예후차이균유 통계학의의(x2=11.15、23.39,P =0.001、0.000).결론 식관린상세포암술전방료후병리적T분기화양성림파결개수시영향예후인소.UICC제7판분기능교준학평개예후,개량제7판N분기후여T분기결합경방편、준학예측정후.
Objective To evaluate the value of the international union against cancer (UICC)stage,pathologic complete response (pCR),and the estimated treatment response as various means for prognostic stratifying patients after surgery in patients with squamous cell carcinoma of the esophagus who received preoperative radiotherapy (RT).Methods A retrospective review was performed on 311 patients with esophageal squamous cell carcinoma who received RT before the esophagectomy. Data collected included the demographics,the RT details,the pathologic findings,and the survival.Prognostic survival was analyzed by Kaplan-Meier method and Logrank test.Results The follow-up rate was 96.5％,89 and 43 patients,respectively were followed up more than 5 and 10 years.In univariate analysis,residual disease and the number of positive lymph node were predictors of the overall survival ( T-pCR,x2 =11.53,P =0.001 ;0,1 -3,≥4,x2=42.13,P=0.000,respectively).Further study found the 7th stage system of UICC cannot (can or cannot) entirely predict the prognosis of this group of patients.If categorizing the stages of their lymph nodes into three groups:N0(0),N1 (1-3) and N2(≥4)),and the modified UICC system can accurately distinguish ypStage Ⅰ with ypStage Ⅱ ( T0.3 N 1 M0 + T3 N0 M0 ) ( x2 =11.15,P =0.001 ) and ypStage Ⅱ with ypStage Ⅲ ( T4 N0-1 M0 and T0-3 N2 M0 ) ( x2 =23.39,P =0.000 ).Conclusions The pathologic post-radiotherapy T stage and the number of positive lymph node are predictors for esophageal squamous cell carcinoma receiving preoperative radiotherapy.The modified UICC stage system can be a better survival predictor than the 7th UICC stage system.
