食管癌术后局部复发患者放射治疗的疗效及其预后影响因素分析

目的：探讨食管癌术后局部复发患者放射治疗疗效及预后影响因素。方法回顾性分析我院2010-2012年37例食管癌术后局部复发患者的临床资料，结合随访资料进行预后因素分析。采用Kaplan-Meier法和Log-rank检验比较生存率，用Cox比例风险模型进行多因素分析。结果37例患者的中位生存期为11个月，1、2、3年生存率分别为45.9%（17/37）、27.0%（7/37）、13.5%（5/37）。单因素分析显示，患者首次治疗后复发间隔时间、放疗剂量、是否同步放化疗、GTV体积以及PS评分与预后相关。多因素分析显示，患者首次治疗后复发间隔时间、放疗剂量、是否同步放化疗、GTV体积为影响预后的独立因素。结论食管癌术后局部复发患者预后差，预后受多种因素影响。初次治疗后密切的随访复查，较早的发现局部复发，通过积极的治疗可能会改善患者预后。

Clinical efficacy of radiotherapy for patients with local recurrence of esophageal carcinoma after curative resection and analysis of prognostic factors

Objective To evaluate the outcome of radiotherapy for local recurrence of esophageal carcinoma after curative resection and to determine the prognostic factors. Methods The clinical data and follow-up data of 37 pa-tients with local recurrence of esophageal squamous cell carcinoma after curative resection were retrospectively re-viewed from 2010 to 2012, combined with analysis of prognostic factors in the patients. Kaplan-Meier method was used to analyze the survival rate. Log-rank test was used to evaluate the difference between the groups. Cox model was used for multivariate analysis. Results The median survival time was 11 months in 37 patients, and the overall 1-, 2-and 3-year survival rates were 45.9%(17/37), 27.0%(7/37), 13.5%(5/37), respectively. Univariate analysis showed that the interval between initial treatment and local failure, radiation dose, treatment methods, GTV volume and ECOG PS were influenc-ing factors of prognosis. Cox multivariate analysis showed that the interval between initial treatment and local failure, radi-ation dose, treatment methods and GTV volume were independent factors influencing prognosis. Conclusion The prog-nosis of patients with local recurrence of esophageal carcinoma after curative treatment is poor, and it is affected by many factors. The regular following-up and checking after the first treatment and the discovery of early local resection could be effective in improving the prognosis of patients through treatment.