中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2014年
5期
392-395
,共4页
张安度%韩春%兰堃田%王澜%孔洁%高超%李晓宁
張安度%韓春%蘭堃田%王瀾%孔潔%高超%李曉寧
장안도%한춘%란곤전%왕란%공길%고초%리효저
食管肿瘤/放射疗法%放射疗法,三维适形%年龄%预后
食管腫瘤/放射療法%放射療法,三維適形%年齡%預後
식관종류/방사요법%방사요법,삼유괄형%년령%예후
Esophageal neoplasms/radiotherapy%Radiotherapy,three-dimensional conformal%Age%Prognosis
目的 观察不同年龄组食管鳞癌患者3DCRT的长期生存情况.方法 回顾分析2003-2008年符合入组条件的全段食管癌Ⅰ—Ⅲ期患者769例,全部采用3DCRT,处方剂量50 ～ 70Gy,1.8 ～2.0 Gy/次,5次/周.Kaplan-Meier法计算OS及LC率,Logrank法检验差异并单因素预后分析,Cox回归模型多因素预后分析.结果 随访率为98.3％.全组患者1、3、5年LC率分别为76.3％、52.8％、48.5％,OS率分别为70.1％、36.2％、23.0％.45～74岁组和75～ 89岁组1、3、5年OS率分别为71.2％、38.8％、24.9％和69.6％、26.6％、15.4％ (P =0.008).多因素预后分析显示年龄分组也是食管癌3DCRT预后影响因素.共死亡620例,45～74岁组死于远处转移比例偏高(23.9％∶14.2％,P=0.009),75 ～ 89岁组非癌性死亡比例偏高(14.1％∶4.9％,P=0.000).结论 不同年龄组食管癌患者接受3DCRT后生存情况不同,老年食管癌患者生存情况较差,非癌性死亡比例偏高可能为生存情况差的重要原因之一.
目的 觀察不同年齡組食管鱗癌患者3DCRT的長期生存情況.方法 迴顧分析2003-2008年符閤入組條件的全段食管癌Ⅰ—Ⅲ期患者769例,全部採用3DCRT,處方劑量50 ～ 70Gy,1.8 ～2.0 Gy/次,5次/週.Kaplan-Meier法計算OS及LC率,Logrank法檢驗差異併單因素預後分析,Cox迴歸模型多因素預後分析.結果 隨訪率為98.3％.全組患者1、3、5年LC率分彆為76.3％、52.8％、48.5％,OS率分彆為70.1％、36.2％、23.0％.45～74歲組和75～ 89歲組1、3、5年OS率分彆為71.2％、38.8％、24.9％和69.6％、26.6％、15.4％ (P =0.008).多因素預後分析顯示年齡分組也是食管癌3DCRT預後影響因素.共死亡620例,45～74歲組死于遠處轉移比例偏高(23.9％∶14.2％,P=0.009),75 ～ 89歲組非癌性死亡比例偏高(14.1％∶4.9％,P=0.000).結論 不同年齡組食管癌患者接受3DCRT後生存情況不同,老年食管癌患者生存情況較差,非癌性死亡比例偏高可能為生存情況差的重要原因之一.
목적 관찰불동년령조식관린암환자3DCRT적장기생존정황.방법 회고분석2003-2008년부합입조조건적전단식관암Ⅰ—Ⅲ기환자769례,전부채용3DCRT,처방제량50 ～ 70Gy,1.8 ～2.0 Gy/차,5차/주.Kaplan-Meier법계산OS급LC솔,Logrank법검험차이병단인소예후분석,Cox회귀모형다인소예후분석.결과 수방솔위98.3％.전조환자1、3、5년LC솔분별위76.3％、52.8％、48.5％,OS솔분별위70.1％、36.2％、23.0％.45～74세조화75～ 89세조1、3、5년OS솔분별위71.2％、38.8％、24.9％화69.6％、26.6％、15.4％ (P =0.008).다인소예후분석현시년령분조야시식관암3DCRT예후영향인소.공사망620례,45～74세조사우원처전이비례편고(23.9％∶14.2％,P=0.009),75 ～ 89세조비암성사망비례편고(14.1％∶4.9％,P=0.000).결론 불동년령조식관암환자접수3DCRT후생존정황불동,노년식관암환자생존정황교차,비암성사망비례편고가능위생존정황차적중요원인지일.
Objective To investigate the long-term survival of esophageal squamous cell carcinoma (ESCC) patients of different ages after three-dimensional conformal radiotherapy (3 DCRT).Methods From July 2003 to September 2008,769 patients with stage Ⅰ-Ⅲ ESCC were eligible for the analysis.All patients were treated with 3DCRT.The prescribed dose was 50-70 Gy (median,60 Gy),1.8-2.0 Gy per fraction,5 fractions per week.The Kaplan-Meier method was used to calculate overall survival (OS) and local control (LC) rates; the log-rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis.Results The follow-up rate was 98.3％.For all patients,the 1-,3-,and 5-year LC rates were 76.3％,52.8％,and 48.5％,respectively,and the 1-,3-,and 5-year OS rates were 70.1％,36.2％,and 23.0％,respectively.The 1-,3-,and 5-year OS rates were 71.2％,38.8％,and 24.9％,respectively,for patients aged 45-74 years,versus 69.6％,26.6％,and 15.4％ for patients aged 75-89 years (P =0.008).Multivariate prognostic analysis showed that age was also a prognostic factor in ESCC patients after 3DCRT.A total of 620 patients died.Patients aged 45-74 years had a significantly higher proportion of individuals that died of distant metastasis (23.9％ vs.14.2％,P =0.009),while patients aged 75-89 years had a significantly higher proportion of individuals that died of non-cancer diseases (14.1％ vs.4.9％,P=0.000).Conclusions Survival varies between ESCC patients of different ages after 3DCRT.The survival of elderly ESCC patients is poor,and the relatively high mortality from non-cancer diseases may be an important reason for poor survival.
