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目的观察食管鳞癌术后三维适形放疗的治疗效果及预后因素。方法回顾性分析新疆医科大学第一附属医院肿瘤中心2006年1月-2013年6月术后行三维适形放疗的食管鳞癌患者63例的临床资料,采用Kaplan-Meier法计算不同民族患者生存率的差异,预后影响因素行Logrank法单因素分析和Cox法多因素分析。结果全组1、3、5年生存率分别为87.3%、59.9%和36.7%,中位生存时间29个月。汉族、哈萨克族、维吾尔族患者的1、3、5年生存率无显著差异。T2、T3、T4期患者的1、3、5年生存率分别为93.3%、77.5%、50.3%,90.9%、60.7%、35.6%和66.7%、33.3%、16.7%(P=0.002)。有无淋巴结转移患者的1、3、5年生存率分别为73.5%、36.6%、21.9%和86.2%、54.2%、31.9%(P=0.017)。II期和III期患者的1、3、5年生存率分别为92.1%、74.5%、47.3%和81.1%、46.3%、24.6%(P=0.001),是否化疗患者的1、3、5年生存率分别为91.3%、66.2%、48.8%和78.6%、46.5%、20.7%(P=0.009)。多因素分析显示:T分期、有无淋巴结转移和是否联合化疗都独立影响食管癌的预后。结论食管癌术后三维适形放疗后的预后影响因素有肿瘤T分期、有无淋巴结转移以及是否联合化疗,不同民族患者生存率无明显差异。
Objective To observe the therapeutic effect and prognostic factors of three-dimensional conformal radiotherapy for esophageal squamous cell carcinoma after operation. Methods The clinical data of 63 patients with esophageal squamous cell carcinoma treated with three-dimensional conformal radiotherapy from January 2006 to June 2013 in Cancer Center of the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. Kaplan-Meier method was used to calculate the survival of patients from different ethnic groups Rate differences, prognostic factors Logrank method univariate analysis and Cox method multivariate analysis. Results The 1, 3, 5 year survival rates were 87.3%, 59.9% and 36.7% respectively, and the median survival time was 29 months. Han, Kazak, Uighur patients 1,3,5-year survival rate was no significant difference. The 1, 3, 5-year survival rates were 93.3%, 77.5%, 50.3%, 90.9%, 60.7%, 35.6% and 66.7%, 33.3% and 16.7% in patients with T2, T3, and T4, respectively (P = 0.002). The 1, 3, 5-year survival rates of patients with or without lymph node metastasis were 73.5%, 36.6%, 21.9% and 86.2%, 54.2% and 31.9%, respectively (P = 0.017). The 1,3 and 5-year survival rates of stage II and III patients were 92.1%, 74.5%, 47.3% and 81.1%, 46.3% and 24.6%, respectively (P = 0.001) Survival rates were 91.3%, 66.2%, 48.8% and 78.6%, 46.5% and 20.7%, respectively (P = 0.009). Multivariate analysis showed: T staging, with or without lymph node metastasis and whether chemotherapy combined with chemotherapy independently affect the prognosis of esophageal cancer. Conclusion The prognostic factors of three-dimensional conformal radiotherapy for esophageal cancer patients with tumor T stage, with or without lymph node metastasis and whether combined with chemotherapy, the survival rate of patients of different ethnic groups no significant difference.