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[目的]探讨适形调强放射治疗食管癌的疗效和影响生存的相关因素。[方法]对79例接受根治性适形调强放疗的食管鳞癌患者,观察患者生存率、局部控制率和死亡原因。Kaplan-Meier法计算患者生存率,Log-rank法比较生存曲线差异。[结果]67例(84.8%)接受了放疗前诱导化疗,64例(81.0%)患者接受同期化疗。中位随访时间12.2个月(3~46个月),中位生存时间为12.2个月(95%CI为9.1~15.3),1、2年总生存率为52.0%、31.0%,1、2年局控率为73.2%、52.1%。病变长度≤5cm和>5cm、病变最大直径≤4cm和>4cm的患者的生存曲线有统计学差异。按中国非手术食管癌临床分期统计出Ⅰ、Ⅱ、Ⅲ期生存曲线有统计学差异。按2009第7版UICC分期绘制的生存曲线差异无统计学意义。[结论]适形调强放疗技术治疗食管癌可得到较好的靶区剂量分布,危及器官保护较好。肿瘤病变长度和肿瘤最大直径与预后相关,中国非手术治疗食管癌的临床分期标准可较好地反映出食管癌放疗患者的预后情况,第7版UICC食管癌分期在非手术食管癌患者预后评估的应用上有局限。
[Objective] To investigate the curative effect and related factors of survival of conformal IMRT esophageal cancer. [Methods] Totally 79 patients with esophageal squamous cell carcinoma who received radical conformal IMRT were selected to observe the survival rate, local control rate and cause of death. Kaplan-Meier method to calculate the survival rate of patients, Log-rank method to compare survival curves. [Results] Sixty-seven patients (84.8%) received chemotherapy before radiotherapy and 64 patients (81.0%) received concurrent chemotherapy. The median follow-up time was 12.2 months (range 3 to 46 months) with a median survival time of 12.2 months (95% CI 9.11 to 15.3). The 1 and 2 year overall survival rates were 52.0% and 31.0% respectively The annual bureau control rate was 73.2%, 52.1%. Survival curves of patients with ≤5 cm and> 5 cm in length, ≤4 cm in diameter and> 4 cm in diameter were statistically different. According to the clinical staging of non-surgical esophageal cancer in China, the survival curves of Ⅰ, Ⅱ and Ⅲ were statistically different. According to the 2009 version of the 7th edition of UICC staging drawn survival curve was no significant difference. [Conclusion] The conformal IMRT is a good target dose distribution for esophageal cancer, which is endangered organ protection. The length of tumor and the maximum diameter of tumor are related to the prognosis. The clinical staging of non-surgical treatment of esophageal cancer in China can better reflect the prognosis of patients with esophageal cancer radiotherapy. The 7th edition of UICC esophageal cancer staging in patients with non-surgical esophageal cancer prognosis assessment There are limitations on the application.