新疆不同民族食管鳞癌术后三维适形放疗的预后影响因素分析

Analysis of prognostic factors of 3DCRT after radical surgery for esophageal squamous cell carcinoma in different ethnics in Xinjiang

目的观察食管鳞癌术后三维适形放疗的治疗效果及预后因素。方法回顾性分析新疆医科大学第一附属医院肿瘤中心2006年1月-2013年6月术后行三维适形放疗的食管鳞癌患者63例的临床资料,采用Kaplan-Meier法计算不同民族患者生存率的差异,预后影响因素行Logrank法单因素分析和Cox法多因素分析。结果全组1、3、5年生存率分别为87.3%、59.9%和36.7%,中位生存时间29个月。汉族、哈萨克族、维吾尔族患者的1、3、5年生存率无显著差异。T2、T3、T4期患者的1、3、5年生存率分别为93.3%、77.5%、50.3%,90.9%、60.7%、35.6%和66.7%、33.3%、16.7%(P=0.002)。有无淋巴结转移患者的1、3、5年生存率分别为73.5%、36.6%、21.9%和86.2%、54.2%、31.9%(P=0.017)。II期和III期患者的1、3、5年生存率分别为92.1%、74.5%、47.3%和81.1%、46.3%、24.6%(P=0.001),是否化疗患者的1、3、5年生存率分别为91.3%、66.2%、48.8%和78.6%、46.5%、20.7%(P=0.009)。多因素分析显示:T分期、有无淋巴结转移和是否联合化疗都独立影响食管癌的预后。结论食管癌术后三维适形放疗后的预后影响因素有肿瘤T分期、有无淋巴结转移以及是否联合化疗,不同民族患者生存率无明显差异。

Objective To observe and evaluate the prognostic factors of 3DCRT after radical surgery for esophageal squamous cell carcinoma（ESCC）.Methods 63 ESCC patients were enrolled to conduct 3DCRT after radical surgery in our hospital from January 2006 to June 2013.Retrospective analysis and KaplanMeier method were selected to calculate survival rate among different ethnics.Logrank test which involves single element and Cox test with multiple factors were chosen to analysis the prognostic factors.ResultsFor all ESCC patients,the 1-year,3-year and,5-year OS were 87.3%,59.9% and 36.7% respectively.The median survival time was 29 months.Among Han,Kazak,Uighur,there were no significant difference between 3-and 5-year survival rates.1,3,5-year survival rate of the periods of T2,T3 and T4were respectively 93.3%,77.5%,50.3%,90.9%,60.7%,35.6% and 66.7%,33.3%,16.7%（P =0.002）.1,3,5-year survival rates of with or without lymph node metastasis were respectively 73.5%,36.6%,21.9%and 86.2%,54.2%,31.9%（P =0.017）.1,3,5-year survival rates of stage II and III were respectively92.1%,74.5%,47.3% and 81.1%,46.3%,24.6%（P =0.001）.1,3,5-year survival of with or without chemotherapy respectively were 91.3%,66.2%,48.8%and 78.6%,46.5%,20.7%（P =0.009）.Multivariate analysis showed that：T stage,lymph node metastasis and combined chemotherapy or not were independently affected the prognosis of patients.Conclusion The prognosis factors for 3DCRT after radical surgery for esophageal squamous cell carcinoma were the survival of tumor T stage,lymph node metastasis,and combined chemotherapy or not,and there were no statistical significances in different ethnics.