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目的分析和评估三维适形放射治疗技术对食管癌患者的疗效及影响预后的因素。方法回顾性分析3年间采用三维适形放疗的66例未手术食管癌患者的临床资料,分析其生存率、局部控制率和影响预后的因素。结果本研究1、3、4年局部控制率分别为65.45%、52.9%、41.9%,1、3、4年生存率分别为56.7%、33.3%、30.3%,中位生存期为13个月。单因素分析显示疗前进食情况、穿孔征象、病变长度、TNM分期、疗后食管X线片评论是影响预后的因素。多因素分析显示疗前是否有穿孔征象、肿瘤长度是独立预后因素。结论三维适形放疗能明显提高部分食管癌患者的局部控制率和生存率,疗前是否有穿孔征象、肿瘤长度是影响预后的独立因素。
Objective To analyze and evaluate the effect of three-dimensional conformal radiotherapy on the prognosis of esophageal cancer patients. Methods The clinical data of 66 patients with esophageal cancer who underwent three-dimensional conformal radiotherapy over three years were retrospectively analyzed. The survival rate, local control rate and prognostic factors were analyzed. Results The local control rates at 1, 3 and 4 years were 65.45%, 52.9% and 41.9%, respectively. The 1,3 and 4-year survival rates were 56.7%, 33.3% and 30.3% respectively. The median survival time was 13 months . Univariate analysis showed that pre-treatment food intake, perforation signs, length of lesion, TNM staging, postoperative esophageal radiographs were the prognostic factors. Multivariate analysis showed signs of perforation before treatment, and tumor length was an independent prognostic factor. Conclusion Three-dimensional conformal radiotherapy can significantly improve the local control rate and survival rate of some esophageal cancer patients. Whether there is a perforation sign before the treatment is an independent factor that affects the prognosis.