食管癌骨转移患者放疗后的生存期预测模型

A Scoring System for Esophagus Carcinoma Patients with Bone Metastases

目的建立一个能预测食管癌骨转移患者放疗后生存时间的模型。方法回顾77例食管癌骨转移放疗患者的生存时间和潜在的影响因素,对所得数据进行K-M分析及COX多因素分析。结果 KPS <70、骨相关事件(病理性骨折、脊髓压迫症)、伴有肝肺脑转移或恶性浆膜腔积液三个因素与预后差有关。根据各因素的风险比(HR)制定了打分规则,按照最终得分将患者分为低危组、中危组、高危组。三组患者的中位生存时间分别为12. 8个月、6. 2个月、3. 0个月,差异有统计学意义。结论食管癌骨转移患者可根据KPS、是否存在骨性并发症、是否伴有肝肺脑转移或恶性浆膜腔积液三个因素进行评分,估算预期生存时间,用以指导放疗方式及后续治疗的选择。

Objective This study aimed to develop a scoring system to predicting the overall survival of esophagus carcinoma patients with bone metastases after RT.Methods The OS(overall survival)and potential influencing factors of 77 esophagus carcinoma patients with bone metastases after RT were retrospectively reviewed.Kaplan-Meier(K-M)analysis and Cox regression analysis was performed on this data one after another.Results Multivariate analysis of variance demonstrated showed that the independent prognostic factors included KPS<70,skeletal-related events(pathologic fracture and spinal cord compression),accompanied with metastasis in hepatic,pulmonary,brain or malignant effusion.Set a scoring rule according to the hazard ratio(HR)in Cox model.The prognostic score was calculated by adding all the scores for individual factors.On the basis of the final score,the patients were divided into low risk group,middle risk group and high risk group.The median survival of the three groups were 12.8 months,6.2 months,and 3.0 months(P<0.05).Conclusion The patients with bone metastasis of esophageal carcinoma estimate the expected overall survival can be scored according to three factors:KPS,skeletal-related events,hepatic,pulmonary,brain metastasis or malignant effusion,can be to guide the choice of radiotherapy methods and follow-up treatment.