110例老年食管癌调强放疗疗效及预后分析

The efficacy and prognosis of intensity-modulated radiotherapy for 110 cases of elderly esophageal cancer

目的探讨老年食管癌患者调强放疗(intensity modulated radiation therapy, IMRT)疗效及相关预后因素。方法回顾性分析2014年1月-2017年3月安徽省合肥市第二人民医院肿瘤科符合条件的110例初治接受 IMRT的年龄65岁以上的食管癌患者的临床疗效及相关预后因素。结果 110例患者,中位年龄77岁;中位生存时间为19. 5个月,1、2、3和5年生存率分别为67%、49%、28%和9%;全组Ⅰ、Ⅱ、Ⅲ级急性放射性肺炎的发生率分别为5. 3%、0. 9%、0. 4%,Ⅰ、Ⅱ、Ⅲ级急性放射性食管炎的发生率分别为36. 2%、4. 8%、2. 1%,Ⅰ、Ⅱ、Ⅲ级骨髓抑制的发生率分别为29. 6%、13. 7%、2. 7%,Ⅰ、Ⅱ、Ⅲ级消化道反应的发生率分别为13. 1%、3. 4%、0. 1%,无Ⅳ级及以上放射性损伤。COX多因素分析显示,病变部位、GTV及治疗方法与患者的预后明显相关。结论 IMRT是老年食管癌患者安全有效的治疗方式之一。

Objective To evaluate the efficacy and related prognostic factors of esophageal carcinoma treated with intensity-modulated radiotherapy（ IMRT） inelderly Patients. Methods From January 2014 to March 2017,110 elderly pat-ients（ age≥65 years） with esophageal carcinoma treated with IMRT in the Department of Oncology,Second People＇s Hospital of Hefei,Anhui Province were analyzed retrospectively. Results Median age was 77 years among 110 patients. The median survival time was 19. 5 months. The 1-,3-and 5-year survival rates were 67%,49%,28% and 9%,respectively. Grade 1,2 and 3 acute radiation pneumonitis incidence was 5. 3%,0. 9%,0. 4%,respectively. Grade 1,2 and 3 acute radiation-induced esophagitis incidence was 36. 2%,48%,2. 1%,respectively. Grade 1,2 and 3 myelosuppression incidence was 29.6%,13. 7%,2. 7%,respectively. Grade 1,2 and 3 radiation-induced digestive reaction incidence was 13. 1% 、3. 4% 、0.1%,respectively. No radiation damage of Class Ⅳ or above. COX multivariate analysis identified tumor location,Gross tumor volume（ GTV） and treatment modality as related prognostic factors for overall survival. Conclusion IMRT is safe and effective in the treatment of elderly patients with esophageal carcinoma.