151例食管癌适形调强放疗预后影响因素分析

Prognostic Factors Analysis on 151 Esophageal Cancer Patients Underwent Three-dimensional Radiotherapy

目的 观察151例行根治性适形调强放射治疗的食管癌患者的1、2、3年生存率,并探讨影响生存率的相关因素。方法选择2007年7月至2010年7月在我院接受三维适形放疗（140例）及调强放疗（11例）的151例食管癌患者,处方剂量57.5～70.0Gy（中位数60 Gy）。采用Kaplan-Meier法计算1、2、3年生存率,Logrank法行单因素预后分析,Cox法行多因素预后分析,其余用χ2检验。结果 随访率为96.2%。全组患者1、2、3年总生存率分别为51.7%、28.5%、16.6%,中位生存时间为13个月。单因素分析显示：T分期、N分期、临床分期、化疗应用、大体肿瘤体积（GTV）、病变长度、CT食管肿瘤最大直径与食管癌适形调强放疗预后密切相关。Cox多因素分析显示：化疗应用、N分期、GTV是影响食管癌适形调强放疗预后的独立因素（P值分别为0.000、0.003、0.001）。结论 化疗应用、N分期、GTV是食管癌适形调强放疗的独立预后因素。

Objective To observe the 1-year, 2-year and 3-year survival rate of esophageal cancer patients underwent conformal intensity modulat- ed radiotherapy, and to explore the impact of relevant factors on survival rate. Methods A total of 151 cases of esophageal cancer patients, who were admitted in our hospital between July 2007 and July 2010 and met the inclusion criteria, were selected for the study. Patients were treated with three- dimension confonnal radiotherapy （140 patients） or intensity- modulated radiotherapy （11 patients ）.The prescribed doses ranged from 57.5 Gy to 70.0 Gy, with a median value of 60 Gy. The 1 -year, 2-year and 3-year survival rate were calculated by Kaplan-Meier method. Logrank method was used for univariate analyses. Cox regression model was used for multivariate analyses. Others were analyzed by ~2. Results The follow- up rate was 96.2%. The 1-year, 2-year and 3-year overall survival rates were 51.7%, 28.5%, and 16.6% with Kaplan-Meier method, respectively, with the median survival time of 13 months. Univariate analysis showed that T stage, N stage, clinical stage, chemotherapy application, GTV size, le- sion length, CT esophageal tumor diameter is closely related to conformal intensity modalated radiotherapy prognosis of esophageal cancer patients. The Cox multivariate analysis showed that the application of chemotherapy, N stage, GTV volume were the independent prognostic factor of esopha- geal cancer patients （P values were 0.000,0.003, and 0.001, respectively）. Conclusion Application of chemotherapy, N stage, GTV volume were the independent prognostic factor of esophageal cancer patients treated with conformal intensity modulated radiotherapy.