血红蛋白浓度与食管癌放射治疗患者局部控制率及远期生存率的相关性

Correlation between hemoglobin concentration and local control rate and long-term survival rate on radiotherapy for esophageal cancer patients

目的探讨血红蛋白(Hb)浓度与食管癌放射治疗患者局部控制率及远期生存率的关系。方法选取2016年1月至2017年1月在我院治疗的食管癌患者88例,均接受放疗治疗,观察随访患者治疗疗效,检测放疗前后Hb水平。结果经放疗后,完全缓解(CR)患者8例,部分缓解(PR)患者30例,稳定(SD)患者29例,疾病进展(PD)患者21例;局部控制率为43.18%;局部控制患者放疗后Hb、放疗后Hb/放疗前Hb比值>1比例分别为(110.15±7.54)g/L和73.68%,明显高于无效患者(P<0.05);局部控制患者病变长度>5 cm、TNM分期Ⅳ期比例分别为34.21%和31.58%,明显低于无效患者(P<0.05);Logistic回归分析显示:放疗后Hb/放疗前Hb比值>1、病变长度及TNM分期是食管癌患者局部控制的影响因素(OR=0.702、2.330和2.729,P<0.05);放疗后Hb/放疗前Hb比值>1患者中位生存时间为30个月,明显长于放疗后Hb/放疗前Hb比值≤1患者(P<0.05)。结论放疗前后Hb情况与食管癌患者局部控制及远期生存有关,值得进一步研究。

Objective To investigate the correlation between hemoglobin(Hb)concentration and local control rate and long-term survival rate on esophageal cancer(EC)patients undergoing radiotherapy(RT).Methods Totally 88 EC patients admitted to our hospital from January 2016 to January 2017 were selected,RT was performing in all patients,therapeutic effect was observed and Hb concentration was measured before and after radiotherapy.Results After radiotherapy,local effective patients was 38(43.18%)including 8 patients with complete remission(CR)and 30 patients with partial remission(PR);the rest were ineffective patients was 50 including 29 patients with stable disease(SD)and 21 patients with progressive disease(PD).In local effective patients,Hb concentration was(110.15±7.54)g/L,percentage of ratio>1(Hb post-RT/Hb bef-RT)was 73.68%,which were significantly higher than those in ineffective patients(P<0.05);percentage of lesion length>5 cm and tumor node metastasis(TNM)classification IV were 34.21%and 31.58%,which were significantly lower than those in ineffective patients(P<0.05);logistic regression analysis showed that influencing factors for local effective patients with EC were ratio>1(Hb post-RT/Hb bef-RT),lesion length and TNM classification(OR=0.702,2.330 and 2.729,P<0.05);the median survival time in the patients with ratio>1(Hb post-RT/Hb bef-RT)was 30 months,which was significantly longer than that in the patients with a ratio≤1(P<0.05).Conclusion For EC patients,Hb concentration in pre-RT and post-RT was related to local control rate and long-term survival rate,and it is worthy of further study.