23例食管多原发癌综合治疗预后分析

Prognostic factors analysis of 23 cases of esophageal multiple primary carcinoma patients treated with multidisciplinary therapy

目的分析食管多原发癌综合治疗疗效及预后影响因素。方法回顾分析2002年1月—2012年6月,该院行综合治疗的23例食管多原发癌患者临床资料,分析局部控制率、生存率及预后影响因素。结果随访率为100%,18人随访满2年。全组1,2,3年局部控制率分别为67.9%,39.6%,26.4%,生存率分别为83.2%,56.0%,33.6%,中位生存期16个月。单因素分析显示病灶长度和照射方式(同野照射与分隔野照射)为预后影响因素(χ2=8.385、6.489,P=0.015、0.011),多因素分析显示照射方式为影响预后因素(χ2=6.917,P=0.009)。结论食管多原发癌治疗失败的主要原因为局部复发,综合治疗有望改善预后。

Objective To evaluate the efficacy of multidisciplinary therapy for esophageal multiple primary carcinoma（ EMPC） and to identify relevant prognostic factors. Methods From Jan 2002 to Jun 2012,23 patients with EMPC treated with multidisciplinary therapy in our hospital were retrospectively analyzed. The local control rates,the survival rates and the related prognostic factors were evaluated with SPSS 13. 0 software. Results The follow-up rate was 100%. The number of patients who completed the 2-year follow-up was 18. The 1-,2-and 3-year local control rates were 67. 9%,39. 6% and 26. 4%,respectively. The 1-,2-and 3-year overall survival rates were 83. 2%,56. 0% and 33. 6%,respectively. The median overall survival was 16 months. Univariate analysis revealed that tumor length and radiotherapy mode（ irradiated in one field or separated fields） were associated with good survival（ χ2= 8. 385,6. 489,P = 0. 015,0. 011）. Multivariate analysis confirmed that radiotherapy mode was independent prognostic factor for survival（ χ2= 6. 917,P = 0. 009）. Conclusions Multidisciplinary therapy is expected to improve the prognosis of multiple primary carcinoma of esophagus,but local recurrence is still a main problem.