156例食管癌术后放疗疗效及预后影响因素分析

Analysis on Effect and Prognostic Factors of Postoperative Radiation Therapy for 156 Cases with Esophageal Cancer

[目的]分析食管癌术后三维适形预防性照射的放疗疗效及预后的影响因素。[方法]回顾性分析156例食管癌术后三维适形预防性放疗的生存率、治疗失败部位和预后影响因素。[结果]156例患者术后放疗后1、3、5年总体生存率分别为88.5%、57.1%和46.0%,中位生存期为49.08个月。单因素分析显示肿瘤大小、淋巴结有无转移、淋巴结转移数、淋巴结转移率、TNM分期与食管癌术后放疗患者预后有关(P均<0.05)。Cox回归分析结果显示肿瘤横径、病理类型、淋巴结转移数、TNM分期是食管癌术后放疗后生存的独立影响因素。[结论]肿瘤横径、淋巴结转移数、TNM分期是食管癌术后放疗后生存的独立影响因素。术后预防性照射对淋巴结阳性患者有益。

[Purpose]To investigate the effect and prognostic factors of prophylactic postoperative threedimensional conformal radiation for esophageal cancer. [Methods] Survival rate,failure sites and prognostic factors of prophylactic postoperative three-dimensional conformal radiation for 156 cases with esophageal cancer were analyzed retrospectively. [Results] The 1-,3- and 5-year overall survival rates of 156 patients with esophageal cancer after postoperative radiotherapy were 88.5%,57.1% and 46.0%,respectively,with median survival 49.08 months. Univariate analysis showed that tumor size,lymph node metastasis,number of lymph node metastasis,rate of lymph node metastasis and TNM stage related to prognosis of patients with esophageal cancer（P0.05）. Cox regression analysis showed that tumor diameter,histological type,number of lymph node metastasis and TNM stage were independent prognostic factors for esophageal cancer with prophylactic postoperative radiation. [Conclusion]The independent prognostic factors of esophageal cancer patients with postoperative radiation include tumor diameter,number of lymph node metastasis and TNM stage. Prophylactic postoperative radiation is beneficial for esophageal cancer patients with lymph node metastasis.