食管癌非手术治疗患者临床特征及同步放化疗预后分析

Clinical characteristics and prognosis of concurrent chemoradiotherapy in patients with esophageal cancer non-surgical treatment

目的分析食管癌非手术治疗患者临床特征,对比食管癌患者不同非手术治疗方式的疗效,为无法接受手术治疗的食管癌患者提供精准、高效的诊疗方案。方法选取2012年1月至2021年12月该院收治的确诊并接受非手术治疗的食管癌患者166例作为研究对象,按不同治疗方案分为同步放化疗组(103例)和姑息治疗组(63例),随访两组患者生存期及生存状态。结果同步放化疗组患者白细胞、血红蛋白水平均明显低于姑息治疗组,1、3、5年生存率均明显高于姑息治疗组,生存时间明显长于姑息治疗组,差异均有统计学意义(P<0.05);两组患者血小板、血小板/淋巴细胞比值比较,差异均无统计学意义(P>0.05)。性别、吸烟史、饮酒史、临床分期、淋巴结转移、治疗方式为影响患者预后的主要影响因素,临床分期的影响最大(风险比=2.500,95%可信区间:1.566~3.992,P<0.001)。结论对中晚期无法接受手术治疗的食管癌患者接受同步放化疗治疗的预后明显优于仅行姑息治疗患者。

Objective To analyze the clinical characteristics of the patients with esophageal cancer nonsurgical treatment,and to compare the curative effects of different non-surgical treatment methods in the patients with esophageal cancer to provide a accurate and high efficiency diagnosis and treatment schemes for the patients with esophageal cancer unacceptable for surgical treatment.Methods A total of 166 patients with definitely diagnosed esophageal cancer and receiving non-surgical treatment in this hospital from January 2012 to December 2021 were selected as the study subjects and divided into the concurrent chemoradiotherapy group(n=103)and palliative treatment group(n=63)according to different treatment methods.Their survival periods and survival status in the two groups were followed up.Results The levels of white blood cells and hemoglobin in the concurrent chemoradiotherapy group were significantly lower than those in the palliative treatment group,the 1,3,5 year survival rates in the concurrent chemoradiotherapy group were significantly higher than those in the palliative treatment group,and the differences were statistically significant(P<0.05);the platelets level and platelet/lymphocyte ratio(PLR)had no statistically significance between the two groups.The gender,smoking history,drinking history,clinical stage,lymph node metastasis and treatment methods were the main risk factors affecting the prognosis.The clinical stage had the greatest impact on the prognosis(hazard ratio=2.500,95%confidence interval:1.566-3.992,P<0.001).Conclusion The patients with middle and advanced esophageal cancer unacceptable for surgical treatment receive the concurrent chemoradiotherapy,the prognosis is significantly superior to that in the patients with only palliative treatment.