颈胸上段食管癌根治性调强放疗±化疗后无复发生存初步分析

目的:探讨接受根治性调强放疗±化疗颈、胸上段食管癌无复发生存(RFS)及影响因素。方法:回顾性分析河北医科大学第四医院2011—2015年间168例颈、胸上段食管癌患者资料。 Kaplan- Meier法计算RFS， Cox模型多因素预后分析。 Logistics模型复发...

Preliminary analysis of recurrence-free survival after radical intensity-modulated radiotherapy combined with/without chemotherapy for upper cervical and thoracic esophageal cancer

Objective To investigate the recurrence-free survival(RFS)and influencing factors of intensity-modulated radiotherapy±chemotherapy(IMRT±C)for the upper thoracic esophageal cancer.Methods The medical records of 168 patients with cervical and upper thoracic esophageal cancer who met the inclusion criteria from January 2011 to December 2015 were retrospectively analyzed.The RFS was calculated by the Kaplan-Meier method.Multivariate prognostic analysis was performed by Cox models.The recurrence factors were identified by the Logistics model.Results The 1-,3-,and 5-year RFS rates were 67.8%,38.0%,and 20.4%,respectively,and the median RFS was 21.9 months.The locoregional recurrence rate was 47.6%(80/168).The recurrence sites were local esophagus(n=63),regional lymph nodes(n=7),and local esophagus+regional lymph node recurrence(n=10).Multivariate analysis showed that hoarseness,cTstaging,combined with chemotherapy,95% PTV₁ exposure dose and GTV average exposure dose were the influencing factors of RFS(P=0.029,<0.001,0.031,0.038,0.020).Logistics model showed that cTstaging,cNstaging,short-term efficacy,irradiationmethod,GTV maximum transverse diameter and PTV average exposure dose were the influencing factors of recurrence(P=0.046,0.022,0.001,<0.001,0.012,0.001).Conclusions Patients with cervical and upper thoracic esophageal cancer treated with radical IMRT combined with/without chemotherapy have a higher locoregional recurrence rate,and the recurrence rate is mainly the esophagus.The independent factors that affect RFS are different from the risk factors of recurrence.