复发食管癌52例放疗的临床分析

Clinical Analysis of 52 Patients with Recurrent Esophageal Carcinoma after Radiotherapy

目的探讨食管癌复发好发部位、三维适形放疗疗效、生存期及预后相关因素,为临床治疗方案的制定提供依据。方法回顾性分析局部区域复发的食管癌52例,K-M方法统计患者生存、COX回归法进行单因素分析、多因素分析、卡方检验分析组间差异。结果食管癌局部区域最好发部位为吻合口、气管食管沟。经放疗后中位生存期为12个月,1年生存率为48%。单因素分析发现,复发放疗后生存期与年龄、放疗剂量、复发部位、复发转移的区域数量、术后接受辅助放疗、复发放疗后接受化疗有关。结论复发后放疗可以缓解症状、延长生存;年轻、复发期别较早者,适当提高放疗剂量并辅以化疗,可以获得较长生存期。

Objective To analyze the distribution of recurrence sites,evaluate the outcome of 3D-CRT for recurrent esophageal cancer after surgery and to determine the prognostic factors. Methods 52 patients with locoregional disease from esophageal cancer were studied retrospectively. The survival rate was calculated by Kap lan-Meier. Chi-square test was used to test the differences of survival rate between patient＇ s subgroups. Multivariable analysis was performed using the Cox proportion hazards model. Results The most frequent sites of recurrence are anastomosis and tracheoesophageal trench . After radiation, the median survival time was 12 months, and the 1 year survival rate was 48%. Age 、dose 、recurrence site 、number of recurrence site postoperative radiation 、adjuvant chemotherapy after radiation were significant prognostic factors in univariate analysis. Conclusion Radiation can help relieve symptoms, a longer survival may be expected for younger patients with higher dose 、earlier period of disease and those with adjuvant chemotherapy.