老年食管鳞状细胞癌放射治疗远期疗效分析

Analysis of long-term efficacy of radiotherapy for elderly patients with esophageal squamous cell carcinoma

目的探讨老年食管鳞癌患者放射治疗远期疗效。方法回顾性分析2013年1月—2016年1月在新疆医科大学附属肿瘤医院接受单纯放射治疗或同步放化疗的≥65岁老年食管鳞癌初治患者共118例。根据治疗方式分为单纯放疗组(57例)和同步放化疗组(61例)。比较两组患者的放疗有效率、生存率、不良反应、死亡原因。采用率和构成比对分类变量进行描述,应用Pearson卡方检验进行单因素分析。结果单纯放疗组和同步放化疗组患者的放疗有效率(68.4%∶86.9%,P=0.016)、不良反应发生率(21.1%∶50.9%,P<0.001)的差异有统计学意义。两组患者的1年总生存率(75.4%∶91.8%,P=0.016)差异有统计学意义,3年总生存率(36.8%∶42.7%,P=0.088)、5年总生存率(10.7%∶18.0%,P=0.746)差异没有统计学意义。两组患者主要死亡原因均为复发合并远处转移。结论与单纯放疗相比,老年食管癌患者的同步放化疗可以显著提高有效率和生存率,但可能会增加不良反应。

Objective To evaluate the long-term efficacy of radiotherapy for elderly patients with esophageal squamous cell carcinoma.Methods Clinical data of 118 elderly patients aged≥65 years with esophageal squamous cell carcinoma treated with radiotherapy alone or concurrent chemoradiotherapy in Cancer Hospital affiliated to Xinjiang Medical University from January 2013 to January 2016 were retrospectively analyzed.All patients were randomly divided into the radiotherapy alone(n=57)and concurrent chemoradiotherapy groups(n=61).The effective rate,survival rate,adverse reactions and causes of death were compared between two groups.Rate and constituent ratio were used to describe the categorical variables,and Pearson Chi-square test was used for univariate analysis.Results The effective rate(68.4%vs.86.9%,P=0.016)and incidence of adverse reactions(21.1%vs.50.9%,P<0.001)between radiotherapy alone and concurrent chemoradiotherapy groups were significantly differed.The 1-year overall survival rate significantly differed between two groups(75.4%vs.91.8%,P=0.016),while no significant differences were observed in the 3-year overall survival rate(36.8%vs.42.7%,P=0.088)and 5-year overall survival rate(10.7%vs.18.0%,P=0.746).The main cause of death in two groups was recurrence combined with distant metastasis.Conclusion Compared with the radiotherapy alone,concurrent chemoradiotherapy can significantly improve the effective rate and survival rate for elderly patients with esophageal squamous cell carcinoma,whereas it may increase the incidence of adverse reactions.