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[目的]分析影响食管癌三维适形放疗(3D-CRT)长期生存的预后因素,为个体化治疗方案的选择和临床分期的修订提供依据。[方法]收集2005~2006年在汕头大学医学院附属肿瘤医院行根治性3D-CRT的食管癌患者236例,对患者的一般临床参数和影像资料进行单因素分析,将筛选出来的有意义的因素纳入Cox模型进行多因素分析。[结果]全组患者中位随访时间为50个月,5年总生存率为26.2%。单因素分析显示病灶部位、X线下病灶长度、病灶横截面最长径、最大横径、最大前后径、壁厚、病灶CT长度、GTV-E、是否外侵、有无淋巴结转移、淋巴结转移模式、淋巴结个数、GTV-LN、GTV-T均是影响预后的因素;多因素分析显示GTV-T、病灶横截面最大径是影响预后的独立因素。[结论]食管癌CT影像上GTV-T和病灶横截面最长径影响食管癌3D CRT的疗效,可以作为制定个体化治疗方案和临床分期的重要指标。
[Objective] To analyze the prognostic factors that affect the long-term survival of three-dimensional conformal radiotherapy (3D-CRT) for esophageal cancer and provide evidence for the selection of individualized treatment plans and revision of clinical stage. [Methods] A total of 236 patients with esophageal cancer who underwent radical 3D-CRT from Cancer Hospital affiliated to Shantou University Medical College from 2005 to 2006 were collected. Univariate analysis was performed on the general clinical parameters and imaging data of the patients. The selected meaningful Factors were included in the Cox model for multivariate analysis. [Results] The median follow-up time was 50 months and the 5-year overall survival rate was 26.2%. Univariate analysis showed that the lesion location, length of lesion under X-ray, longest diameter of transverse section, maximum transverse diameter, maximum anteroposterior diameter, wall thickness, CT length of lesion, GTV-E, invasion and invasion, lymph node metastasis and lymph node metastasis GTV-LN and GTV-T were the prognostic factors. Multivariate analysis showed that the maximum diameter of GTV-T and lesion cross-section were independent prognostic factors. [Conclusion] The effect of GTV-T and the longest diameter of lesion cross section on CT images of esophageal cancer affects the efficacy of 3D CRT in esophageal cancer, which can be used as an important index to formulate individualized treatment plans and clinical staging.