中华放射医学与防护杂志
中華放射醫學與防護雜誌
중화방사의학여방호잡지
Chinese Journal of Radiological Medicine and Protection
2015年
4期
270-273
,共4页
钟胜%吴清泉%王万伟%陶光州%彭进%朱卫国
鐘勝%吳清泉%王萬偉%陶光州%彭進%硃衛國
종성%오청천%왕만위%도광주%팽진%주위국
食管癌%术前放化疗%完全缓解%影像学%预后
食管癌%術前放化療%完全緩解%影像學%預後
식관암%술전방화료%완전완해%영상학%예후
Esophageal carcinoma%Preoperative chemoradiotherapy%Complete response%Imaging%Prognosis
目的 回顾性分析Ⅱ/Ⅲ期食管癌术前放化疗后影像学评价对预后的影响.方法 对有完整随访资料的145例Ⅱ/Ⅲ期食管癌术前放化疗患者进行回顾性分析.分析内容包括术后病理完全缓解(pCR)与未达完全缓解(NpCR)、X射线造影完全缓解(xCR)与未完全缓解(NxCR)及实体瘤疗效评价标准(RECIST)完全缓解(rCR)与未完全缓解(NrCR)的总生存率,并进行多因素分析.结果 全部145例患者,pCR率33.8％,xCR率42.8％,rCR率38.6％.pCR患者与NpCR患者1、3、5年总生存率分别为87.8％、79.6％、61.2％与75％、40.6％、24.0％,差异有统计学意义(x2=20.215,P＜0.05);xCR患者与NxCR患者1、3、5年总生存率分别为80.6％、66.1％、51.6％与75％、44.6％、25.3％,差异有统计学意义(x2=8.895,P＜0.05);rCR患者与NrCR患者1、3、5年总生存率分别为83.9％、69.6％、53.6％与76.4％、46.1％、25.8％,差异有统计学意义(x2=10.862,P ＜0.05),Cox模型进行多因素分析显示pCR是独立预后因素(HR=0.333,95％ CI:0.200 ～0.554,P ＜0.05).结论 xCR、rCR较NxCR、NrCR明显提高了生存率,可以指导临床进行疗效判断;pCR为独立预后因素,术后pCR依然是食管癌术前同步放化疗疗效判断的金标准.
目的 迴顧性分析Ⅱ/Ⅲ期食管癌術前放化療後影像學評價對預後的影響.方法 對有完整隨訪資料的145例Ⅱ/Ⅲ期食管癌術前放化療患者進行迴顧性分析.分析內容包括術後病理完全緩解(pCR)與未達完全緩解(NpCR)、X射線造影完全緩解(xCR)與未完全緩解(NxCR)及實體瘤療效評價標準(RECIST)完全緩解(rCR)與未完全緩解(NrCR)的總生存率,併進行多因素分析.結果 全部145例患者,pCR率33.8％,xCR率42.8％,rCR率38.6％.pCR患者與NpCR患者1、3、5年總生存率分彆為87.8％、79.6％、61.2％與75％、40.6％、24.0％,差異有統計學意義(x2=20.215,P＜0.05);xCR患者與NxCR患者1、3、5年總生存率分彆為80.6％、66.1％、51.6％與75％、44.6％、25.3％,差異有統計學意義(x2=8.895,P＜0.05);rCR患者與NrCR患者1、3、5年總生存率分彆為83.9％、69.6％、53.6％與76.4％、46.1％、25.8％,差異有統計學意義(x2=10.862,P ＜0.05),Cox模型進行多因素分析顯示pCR是獨立預後因素(HR=0.333,95％ CI:0.200 ～0.554,P ＜0.05).結論 xCR、rCR較NxCR、NrCR明顯提高瞭生存率,可以指導臨床進行療效判斷;pCR為獨立預後因素,術後pCR依然是食管癌術前同步放化療療效判斷的金標準.
목적 회고성분석Ⅱ/Ⅲ기식관암술전방화료후영상학평개대예후적영향.방법 대유완정수방자료적145례Ⅱ/Ⅲ기식관암술전방화료환자진행회고성분석.분석내용포괄술후병리완전완해(pCR)여미체완전완해(NpCR)、X사선조영완전완해(xCR)여미완전완해(NxCR)급실체류료효평개표준(RECIST)완전완해(rCR)여미완전완해(NrCR)적총생존솔,병진행다인소분석.결과 전부145례환자,pCR솔33.8％,xCR솔42.8％,rCR솔38.6％.pCR환자여NpCR환자1、3、5년총생존솔분별위87.8％、79.6％、61.2％여75％、40.6％、24.0％,차이유통계학의의(x2=20.215,P＜0.05);xCR환자여NxCR환자1、3、5년총생존솔분별위80.6％、66.1％、51.6％여75％、44.6％、25.3％,차이유통계학의의(x2=8.895,P＜0.05);rCR환자여NrCR환자1、3、5년총생존솔분별위83.9％、69.6％、53.6％여76.4％、46.1％、25.8％,차이유통계학의의(x2=10.862,P ＜0.05),Cox모형진행다인소분석현시pCR시독립예후인소(HR=0.333,95％ CI:0.200 ～0.554,P ＜0.05).결론 xCR、rCR교NxCR、NrCR명현제고료생존솔,가이지도림상진행료효판단;pCR위독립예후인소,술후pCR의연시식관암술전동보방화료료효판단적금표준.
Objective Retrospectively analyzed the predictive value of imaging evaluation in stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy.Methods A total of 145 stage Ⅱ/Ⅲ esophageal carcinoma pantients were enrolled.We analyzed the overall survival rates of the patients with pathological complete response (pCR) and those without (NpCR),X-film complete response (xCR) and those without (NxCR),RECIST complete response (rCR) and those without (NrCR).And we used Cox model for multivariate analysis.Results The rates of pCR,xCR and rCR were 33.8％,42.8％ and 38.6％ for all patients,respectively.The 1-,3-5-year overall survival rates were 87.8％,79.6％,61.2％ for pCR patients and 75％,40.6％,24.0％ for NpCR patients (x2 =20.215,P ＜0.05),respectively;The 1-,3-5-year overall survival rates were 80.6％,66.1％,51.6％ for xCR patients and 75％,44.6％,25.3％ for NxCR patients(x2 =8.895,P ＜0.05),respectively;The 1-,3-5-year overall survival rates were 83.9％,69.6％,53.6％ for rCR patients and 76.4％,46.1％,25.8％ for NxCR patients(x2 =10.862,P ＜ 0.05),respectively.Multivariate survival analysis using Cox regression model showed that pCR was a positive independent prognostic factor (HR =0.333,95％ CI:0.200-0.554,P ＜ 0.05).Conclusions Short-term imaging evaluation could effectively predict the prognosis of stage Ⅱ/Ⅲ esophageal carcinoma patients treated with preoperative chemoradiotherapy.And pCR was a positive independent prognostic factor.
