目的探讨三维适形(3DCRT)放疗用于高龄食管癌患者的短期疗效及长期预后。方法回顾性分析经胃镜病理与食管X线检测确诊的高龄(75岁以上)食管癌患者80例临床资料,所有患者均行3DCRT放疗,对可能影响其短期治疗效果的因素进行分析,同时对患者行电话随访,每3个月随访1次,分析3DCRT放疗后的近期及远期治疗效果,计算患者1年、2年与3年生存率状况,对死亡患者数量和死因详细记录,同时观察患者不良反应出现情况。结果治疗1个月后CR患者27例,PR患者45例,SD患者5例,PD患者3例,总的有效率为90%。单因素分析显示患者进食梗阻程度和病灶长度与短期疗效有关(P <0. 05);多因素分析显示,影响患者短期疗效的独立影响因素为病灶长度(OR=0. 173,95%CI=0. 782~1. 073,P <0. 05)。截止2017年10月,死亡患者64例,其中7例为肺部感染引发呼吸衰竭、31例为淋巴结及远处转移、19例为局部复发、其他因素7例。患者1年生存率66. 25%、2年生存率36. 25%、3年生存率20. 0%,平均生存时间(21. 7±5. 3)月。结论 3DCRT对高龄食管癌患者短期治疗效果理想,同时可提升患者生存率和生存质量,安全性较高。
Objective To analyze the short-term effect and long-term prognosis of elderly patients with esophageal cancer by three-dimensional conformal radiotherapy( 3 DCRT). Methods A retrospective analysis of 80 elderly patients( 75 years of age) with esophageal cancer confirmed by gastroscopic pathology and esophageal X-ray examination. All patients underwent3 DCRT radiotherapy and collected The clinical data of the patients were analyzed on the factors that may affect their short-term therapeutic effect. At the same time,the patients were followed up by phone and followed up every three months to analyze the short-term and long-term therapeutic effects after 3 DCRT radiotherapy. 3-year survival rate,detailed records of the number of deaths and causes of death,and observe the patient’s adverse reaction. Results In one month,there were 27 CR patients,45 PR patients,5 SD patients and 3 PD patients. The total effective rate was 90%. Univariate analysis showed that there was a significant difference in short-term effect between obstruction and lesion length Statistical significance( P < 0. 05) Multivariate analysis showed that the independent influencing factors of short-term curative effect were length of lesion( OR = 0. 173,95% CI = 0. 782~ 1. 073,P < 0. 05);as of October 2017,64 patients died,of which 7 were lung Infection caused respiratory failure,31 cases of lymph node and distant metastasis,19 cases of local recurrence,other factors in 7 cases. The 1-year survival rate was 66. 25%,the2-year survival rate was 36. 25%,the 3-year survival rate was 20. 0% and the average survival time was 21. 7 ± 5. 3 months. Conclusion 3 DCRT is effective in short-term treatment of elderly patients with esophageal cancer,and can improve the survival rate and quality of life of patients with high safety.
The Practical Journal of Cancer
Three dimensional conformal radiotherapy
Short term effect