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目的探讨≥70岁食管鳞癌患者根治性放化疗的疗效及预后的影响因素。方法回顾性分析2009年1月至2015年6月收治的293例接受根治性放化疗的年龄≥70岁的食管鳞癌初治患者的临床资料,其中同步放化疗113例,单纯放疗180例。采用Kaplan-Meier法计算生存率并进行log-rank检验及单因素分析,Cox回归模型行多因素分析。结果 1、2、3年生存率分别为68.8%、40.3%和27.2%,中位生存时间为21个月(95%CI为18.6~23.4个月)。同步放化疗和单纯放疗3年生存率分别为32.3%和23.8%(P=0.021)。单因素分析显示肿瘤长度、临床分期和治疗方式是影响总生存率的因素(P=0.010,0.000和0.021)。多因素分析显示临床分期、治疗方式是影响总生存率的独立预后因素(P=0.001和0.012)。结论对于老年食管鳞癌患者,三维适形放疗是安全有效的,同步放化疗能够提高患者治疗效果。
Objective To investigate the curative effect and prognostic factors of radical radiochemotherapy in patients with esophageal squamous cell carcinoma of the age ≥70 years. Methods The clinical data of 293 patients with esophageal squamous cell carcinoma who underwent radical chemoradiotherapy from January 2009 to June 2015 were retrospectively analyzed. Among them, 113 cases received concurrent chemoradiotherapy and 180 cases received radiotherapy alone. Kaplan-Meier method was used to calculate the survival rate and log-rank test and univariate analysis, Cox regression model was multivariate analysis. Results The 1-, 2- and 3-year survival rates were 68.8%, 40.3% and 27.2%, respectively. The median survival time was 21 months (95% CI 18.6-23.4 months). The 3-year survival rates of concurrent chemoradiation and radiotherapy alone were 32.3% and 23.8%, respectively (P = 0.021). Univariate analysis showed that tumor length, clinical stage and treatment were the factors influencing overall survival (P = 0.010, 0.000 and 0.021). Multivariate analysis showed that clinical stage and treatment were independent predictors of overall survival (P = 0.001 and 0.012). Conclusion For elderly patients with esophageal squamous cell carcinoma, three-dimensional conformal radiotherapy is safe and effective, and concurrent chemoradiotherapy can improve the therapeutic effect of the patients.