原发性输尿管癌术后辅助放疗效果分析

Effect analysis of postoperative adjuvant radiotherapy for primary ureteral cancer

目的回顾性分析根治性切除术后的原发性输尿管癌患者的辅助放疗效果。方法收集2008年1月~2017年12月期间在我院接受根治性切除术的77例原发性输尿管癌患者,其中接受术后辅助放疗的患者采用三维适形或调强放疗技术,放疗的中位剂量为46 Gy(45~60 Gy),分次剂量为2.0 Gy(1.8~2.2 Gy),每周5次。比较术后放疗组与术后未放疗组在无病生存期及总生存期方面的差异。结果两组在年龄、性别、临床分期、病理分级、有无腰腹痛、有无肉眼血尿、是否接受辅助化疗方面比较均无统计学差异(P均>0.05)。两组在总生存期及无病生存期方面比较均无统计学差异(P均>0.05)。多因素分析显示,临床分期是影响原发性输尿管癌无病生存期的独立预后因子(P<0.05)。结论术后辅助放疗未能改善原发性输尿管癌患者的总生存期和无病生存期,早诊早治是提高原发性输尿管癌患者生存期的关键。

Objective To retrospectively analyze the effect of adjuvant radiotherapy in patients with primary ureteral cancer after radical resection.Methods 77 patients with primary ureteral cancer who underwent radical resection in our hospital from January 2008 to December 2017 were enrolled.Among them,the patients underwent postoperative three-dimensional conformal or intensity-modulated adjuvant radiotherapy.The median dose of radiotherapy was 46 Gy(45-60 Gy)and the divided dose was 2.0 Gy(1.8-2.2 Gy),5 times a week.The differences in disease-free survival and overall survival between the postoperative radiotherapy group and the postoperative non-radiotherapy group were compared.Results There was no significant difference in the age,gender,clinical stage,pathological grade,presence or absence of lumbar and abdominal pain,presence or absence of gross hematuria,and whether to receive adjuvant chemotherapy in the postoperative radiotherapy between the postoperative radiotherapy group and the postoperative non-radiotherapy group(P>0.05).There was no significant difference between the two groups in terms of overall survival and disease-free survival(P>0.05).Multivariate analysis showed that clinical stage was an independent prognostic factor affecting the disease-free survival of primary ureteral cancer(P<0.05).Conclusion Postoperative adjuvant radiotherapy fails to improve the overall survival and disease-free survival of patients with primary ureteral cancer.Early diagnosis and early treatment is the key to improve the survival of patients with primary ureteral cancer.