饮酒与食管癌放疗疗效及预后相关性分析

Correlation Analysis Between Alcohol Consumption and Radiotherapy Efficacy as Well as Prognosis in Esophageal Carcinoma

目的探讨饮酒对食管癌放疗后近期疗效及远期预后的影响。方法选取2011-01/2014-01月在作者医院行根治性放疗的食管癌患者170例,平均每月饮酒超过一次为饮酒,分为饮酒组(n=104),非饮酒组(n=66)。χ~2检验对比两组患者临床资料及放疗有效率,Kaplan-Meier法计算生存率,Log-rank检验各组别之间的生存差异。结果饮酒组患者放疗有效率低于非饮酒组患者(P=0.004),轻中度饮酒患者放疗有效率高于重度饮酒患者(P=0.006)。患者近期疗效与病变长度、临床分期、放疗剂量及有无化疗史有关(P均<0.05)。饮酒患者1、2、3年总生存率均低于非饮酒患者(P=0.002)。单因素分析提示患者预后与年龄、卡氏评分、肿瘤部位、直径、长度、淋巴结转移、T分期、临床分期、化疗史、放疗剂量、近期疗效相关(P均<0.05)。结论非饮酒食管癌患者放疗有效率及远期生存率高于饮酒患者,食管癌患者预后受多因素影响。

Objective To explore the effects of alcohol consumption on short-term efficacy and long-term prognosis in esophageal carcinoma after radiotherapy. M ethods A total of 1 7 0 esophageal carcinoma patients treated with radiotherapy in authors＇ hospital from January 2 0 1 1 to January 2 0 1 4 were retrospectively analyzed. The average monthly drink was more than once as alcohol consumption. All patients were divided into alcohol group（ n = 1 0 4） and non-alcohol group（ n = 6 6）. The clinical data and effective rates of radiotherapy between two groups were compared by χ~2 test,and the survival rates were calculated by using the Kaplan-Meier method,and Log-rank analysis was used to test survival differences between each groups. Results The effective rate of radiotherapy in alcohol group was lower than that in nonalcohol group（ P = 0. 0 0 4）,and the effective rate of radiotherapy in mild to moderate drinkers were higher than that in severe drinkers（ P = 0. 0 0 6）. The short-term efficacy was correlated with lesion length,clinical stage,radiotherapy dose and the history of chemotherapy（ all P〈0. 0 5）. The 1-year,2-year and 3-year overall survival rates in drinkers were less than non-drinkers（ P = 0. 0 2）. Univariate analysis showed patients ＇ prognosis was related to age,Karnofsky score,tumour location,diameter,length,lymph node metastasis,T stage,clinical stage,chemotherapy history,radiatherapy dose and short-term efficacy（ all P〈0. 0 5）. Conclusion The effective rate of radiotherapy and long-term survival rate in non-drinking patients are higher than those in drinking patients. The prognosis is influenced by many factors.