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目的:分析伴锁骨上淋巴结转移食管癌患者的放射治疗的疗效及其预后影响因素,进一步评价食管癌临床分期。方法:回顾性分析资料完整的68例接受三维适形放疗的初治食管癌伴锁骨上淋巴结转移的患者,对预后生存进行单因素和多因素分析,锁骨上淋巴结转移与食管癌临床分期的关系及其对预后的影响。结果:全组患者原发灶治疗后完全缓解(CR)26例,部分缓解(PR)33例,无变化(NR)9例。全组锁骨上转移淋巴结治疗后CR49例,PR 19例,总有效率为100%。全组1、2、3年生存率分别为51.4%、31.0%和15.0%,中位生存期15.0个月。单因素分析表明病变部位、病变长度、原发灶放疗剂量、腹腔淋巴结转移、锁骨上转移淋巴结的大小及化疗为影响预后的因素。其中病变部位、原发灶放疗剂量、锁骨上转移淋巴结的大小及化疗为独立预后影响因素。食管胸下段癌患者的生存率及中位生存期均最低。结论:放化疗联合者可作为中晚期食管癌的主要治疗方法,胸上段食管癌伴锁骨上淋巴结转移者应归为区域淋巴结转移、
Objective: To analyze the efficacy and prognostic factors of radiotherapy in patients with esophageal cancer with supraclavicular lymph node metastasis and further evaluate the clinical stage of esophageal cancer. Methods: A retrospective analysis of 68 patients with newly diagnosed esophageal cancer with supraclavicular lymph node metastasis undergoing three-dimensional conformal radiotherapy was performed. Univariate and multivariate analyzes were performed on the prognosis of the patients. The relationship between supraclavicular lymph node metastasis and clinical stage of esophageal cancer And its impact on prognosis. Results: Twenty-six patients had complete remission (CR), 33 had partial response (PR) and 9 had no change (NR). The whole group of clavicular lymph node metastasis after CR49 cases, PR 19 cases, the total effective rate was 100%. The overall 1, 2, 3-year survival rates were 51.4%, 31.0% and 15.0%, respectively. The median survival time was 15.0 months. Univariate analysis showed that the location of the lesion, the length of the lesion, the radiation dose of the primary tumor, the metastasis of the abdominal lymph node, the size of the supraclavicular lymph node and the prognosis of the patients were the same. Among them, the location of lesion, the dose of primary tumor radiotherapy, the size of supraclavicular lymph node metastasis and chemotherapy were the independent prognostic factors. Patients with lower esophageal cancer had the lowest survival rate and median survival. Conclusion: Radiotherapy and chemotherapy combination can be used as the main treatment of advanced esophageal cancer, upper esophageal cancer with supraclavicular lymph node metastasis should be classified as regional lymph node metastasis,