CAJ | 학술논문

目的探讨应用调强技术进行食管癌根治性放疗患者淋巴引流区预防照射的价值,筛选出淋巴引流区预防照射的适合人群,以进一步提高局部控制,改善长期生存.方法对根治性放疗的食管癌初治患者进行同期对照研究,完成治疗计划且资料完整可供分析者148例,74例接受选择性淋巴引流区预防照射(ENI),74例接受累及野照射(IFI).采用Kaplan-Meier法计算两组患者局部控制率和生存率并进行单因素和多因素预后分析.结果 ENI组与IFI组1、3、5年局部控制率分别为72.5％、52.8％、50.6％和58.4％、35.8％、21.9％(x2=7.881,P＜0.05).ENI组与IFI组1、3、5年生存率分别为74.3％、44.2％、24.5％和68.9％、27.6％、15.9％(x2=1.903,P＜0.05).多因素分析发现临床T分期、病变部位、照射方式是影响全组患者局部控制的独立性因素,T分期、N分期、钡餐造影长度和化疗是影响全组患者生存的独立性因素.结论 ENI组的局部控制率较IFI显著提高,早期和胸中段食管癌患者行ENI照射局部控制及生存均能获益.
목적 탐토응용조강기술진행식관암근치성방료환자림파인류구예방조사적개치,사선출림파인류구예방조사적괄합인군,이진일보제고국부공제,개선장기생존.방법 대근치성방료적식관암초치환자진행동기대조연구,완성치료계화차자료완정가공분석자148례,74례접수선택성림파인류구예방조사(ENI),74례접수루급야조사(IFI).채용Kaplan-Meier법계산량조환자국부공제솔화생존솔병진행단인소화다인소예후분석.결과 ENI조여IFI조1、3、5년국부공제솔분별위72.5％、52.8％、50.6％화58.4％、35.8％、21.9％(x2=7.881,P＜0.05).ENI조여IFI조1、3、5년생존솔분별위74.3％、44.2％、24.5％화68.9％、27.6％、15.9％(x2=1.903,P＜0.05).다인소분석발현림상T분기、병변부위、조사방식시영향전조환자국부공제적독립성인소,T분기、N분기、패찬조영장도화화료시영향전조환자생존적독립성인소.결론 ENI조적국부공제솔교IFI현저제고,조기화흉중단식관암환자행ENI조사국부공제급생존균능획익.
Objective To explore the value of elective nodal prophylactic irradiation with intensity modulated radiotherapy(IMRT) for esophageal carcinoma.Screening patients who are suitable for elective nodal prophylactic irradiation (ENI),in order to improve locoregional control and overall survival.Methods The concurrent control study was conducted to esophageal cancer patients who were treated by definitive radiotherapy.A total of 148 patients finished treatment were identified.Seventy-four patients received ENI,while the other seventy-four patients received involved-field irradiation (IFI).Kaplan-Meier method was used for calculation of locoregional control rates and overall survival rates.The univariate and multivariate analysis of prognostic factors were also tested.Results The 1-,3-,and 5-year locoregional control rates of ENI group and IFI group were 72.5％,52.8％,50.6％ and 58.4％,35.8％,21.9％ (x2 =7.881,P ＜0.05),respectively.The 1,3,and 5 years survival rates of the ENI group and IFI group were 74.3％,44.2％,24.5％ and 68.9％,27.6％,15.9％ (x2 =1.903,P ＜ 0.05),respectively.In Cox multivariate analysis,clinical T stage,tumor location,different radiotherapy region were independent factors for the locoregional control of all patients,and clinical T,N stage,the length of esophageal barium meal and chemotherapy were independent factors for the overall survival of all patients.Conclusions Esophageal carcinoma patients treated with ENI could achieve better locoregional control than those treated with IFI.Esophageal carcinoma patients with early stage or middle thoracic lesion could benefit from ENI for local control and overall survival.