CAJ | 학술논문

目的：探讨三维适形放射治疗（3 DCRT）食管癌的长期疗效及其影响预后的因素。方法回顾性分析新疆医科大学附属肿瘤医院2003-2007年58例接受3DCRT的食管癌患者的临床资料，其中单纯放疗23例，序贯放化疗35例，临床分期为Ⅱ期24例，Ⅲ期34例。观察近期疗效、局部控制率、生存率。采用 Kaplan Meier 法计算局部控制率和生存率等，预后影响因素行 Logrank 单因素分析和 Cox法多因素分析。结果随访率为96．6％，随访满7 a者7例。全组患者治疗后总有效率（CR＋PR）为93．1％。1、3、5、7 a局部控制率分别为78％、61％、48％、39％。1、3、5、7 a生存率分别为77．6％、46．6％、22．4％、12．1％。单因素预后分析显示，治疗前进食情况、病变部位、病变长度、临床分期、照射剂量为影响生存的因素（χ2＝6．723、5．594、8．986、29．375、5．883，P ＝0．010、0．008、0．029、0．000、0．015）；多因素预后分析显示，临床分期、治疗前进食情况、照射剂量是影响患者生存的独立因素（χ2＝23．899、9．087、5．090，P ＝0．000、0．003、0．024）。结论食管癌3DCRT后局部控制率和长期生存率可以提高。治疗前进食情况、临床分期和照射总剂量为其预后影响因素。
목적：탐토삼유괄형방사치료（3 DCRT）식관암적장기료효급기영향예후적인소。방법회고성분석신강의과대학부속종류의원2003-2007년58례접수3DCRT적식관암환자적림상자료，기중단순방료23례，서관방화료35례，림상분기위Ⅱ기24례，Ⅲ기34례。관찰근기료효、국부공제솔、생존솔。채용 Kaplan Meier 법계산국부공제솔화생존솔등，예후영향인소행 Logrank 단인소분석화 Cox법다인소분석。결과수방솔위96．6％，수방만7 a자7례。전조환자치료후총유효솔（CR＋PR）위93．1％。1、3、5、7 a국부공제솔분별위78％、61％、48％、39％。1、3、5、7 a생존솔분별위77．6％、46．6％、22．4％、12．1％。단인소예후분석현시，치료전진식정황、병변부위、병변장도、림상분기、조사제량위영향생존적인소（χ2＝6．723、5．594、8．986、29．375、5．883，P ＝0．010、0．008、0．029、0．000、0．015）；다인소예후분석현시，림상분기、치료전진식정황、조사제량시영향환자생존적독립인소（χ2＝23．899、9．087、5．090，P ＝0．000、0．003、0．024）。결론식관암3DCRT후국부공제솔화장기생존솔가이제고。치료전진식정황、림상분기화조사총제량위기예후영향인소。
Objective To observe the clinical effects and prognostic factors of Esophageal Carcinoma treated by three dimensional conformal Radiation therapy(3DCRT).Methods Fifty eight patients with esophageal carcinoma,who received radical 3DCRT between Jul 2003 and Jan 2007,were included in the study.Of them,23 patients received radiotherapy alone,35 patients received sequential chemorediotherapy,Ⅱ stage 24,Ⅲ stage 34.The long term effect,1,3,5,7-year local regionalcontrol rates and survival rates were in-vestigated.The local regional control rates and survival were calculated by the Kaplan-Meier method.Uni-variate prognostic factor was analyzed by Longrank method.Multivariate prognostic factor was analyzed u-sing Cox model.Results The follow-up rate was 96.6%.The numbers of patients followed-up with 7 years was 7.Immediate response rate(CR+PR)was 93.1%.The 1,3,5 and 7-year local control rates were 78%,61%,48% and 39% respectively.The 1,3,5 and 7-year survival rates were 77.6%,46.6%, 22.4%,12.1% respectively.Longrank analysis showed swallow embarrassment before treatment,tumor location,tumour length,clinical stage and Irradiation dose were prognostic factors for the survival(χ2=6.723,5.594,8.986,29.375,5.883,P=0.010,0.008,0.029,0.000,0.015).Multivariate analysis showed clinical stage,swallow embarrassment before treatment and Irradiation dose were important influential factors for the survival.Conclusion 3DCRT can improve local control rate and the survival rate with ac-ceptable side effects.Clinical stage,swallow embarrassment before treatment and Irradiation dose were prognostic factors for the survival.