304例放射治疗为主的食管癌CT分期研究

CT staging of esophageal carcinoma in 304 patients treated chiefly by radiotherapy

目的 评价食管癌CT分期对判断预后的价值。方法 回顾性分析 30 4例经放射治疗为主的食管癌治疗前CT资料 ,比较CT分期与生存率的关系。常规分割 12 6例 ,剂量 5 5～ 6 5Gy ,2 7～35分次 ,5 .5～ 7.0周 ;后程加速超分割 178例 ,剂量 5 5～ 6 0Gy ,33～ 36分次 ,4 .5～ 5 .5周。结果 T1+T2期与T3、T4期 1、3、5年生存率差异有极显著性意义 (χ2 =12 .90 ,P <0 .0 1;χ2 =14 .2 0 ,P <0 .0 1) ,T3期与T4期生存率差异无显著性意义 (χ2 =0 .2 0 ,P >0 .0 5 )。有区域淋巴结转移的生存率明显低于无淋巴结转移的 (χ2 =4 .2 0 ,P <0 .0 5 ) ,有远地转移病例生存率明显降低。结论 CT检查是非手术食管癌比较理想的临床分期方法 ,对判断其预后有很大帮助。

Objective To evaluate the feasibility of CT staging for esophageal cancer. Methods A retrospective analysis of 304 patients treated,from Jan. 1996 to Dec. 1998 chiefly with radiotherapy(126 conventional radiotherapy,55-65 Gy/27-35 fx/5.5-7.0 w;178 late-course accelerated hyperfractionated radiotherapy ,55-60 Gy/33-36 fx/ 4.5 -5.5 w)complete with CT data before treatment was done. The long survival was compared with pre-therapy CT findings and CT staging. ResultsThe survival rate of stage T1+T2 was very significantly different from those lesion with stage T3,T4(χ 2=12.90,P<0.01;χ 2=14.20,P<0.01),whereas insignificance was found between the survival rate of stage T3 and stage T4(χ 2=0.20,P>0.05).The survival rates of patients positive for lymph nodes or distant metastasis were lower. Conclusion CT staging is quite optimal for non-operable esophageal cancer in clinical staging,as it is conducive to predict the prognosis.