肛管癌放化疗疗效及预后因素分析

目的 分析肛管癌放化疗的长期疗效和影响预后的因素.方法 对1984年至2005年单纯放疗、放化疗同步治疗的286例肛管鳞状上皮细胞癌患者临床资料进行分析.结果 平均随访期65个月.5年总生存率66.4%,无瘤生存率64.8%,无复发生存率67%.影响无病生存率的因素:肿瘤大小(<40mm)(RR2.1),区域淋巴结转移(RR2.4),第一阶段放疗肿瘤消退情况(>75%)(RR1.9);5年局部控制率为71%,Ⅰ、Ⅱ、ⅢA、ⅢB期患者分别为88%、69%、77%、60%.影响局控率的因素为:肿瘤大小(RR 2.5)、第一阶段放疗肿瘤消退情况(RR 2.4).结论 肿瘤大小、临床分期、第一阶段放疗肿瘤消退情况是影响患者局部控制率、总生存率、无瘤生存率的主要因素.

Analysis of the results and prognostic factors after conservative treatment of anal canal cancer

Objective To analyze the long-term results and prognostic factors of the anal canal cancer after conservative treatment. Methods From 1984 to 2005,286 patients were treated by exclusive radiotherapy or chemoradiotherapy for an epidermoid cancer of anal canal. Results The mean follow-up was 65 months. The 5-year-overall survival and 5-year disease free survival rate were 66.4 % and 64.8 % respectively. In multivariate analysis, the tumor size(<40 mm) (RR 2.1), node involvement (RR 2.4), and poor response(>75 %) to first course irradiation (RR 1.9) were factors for disease free survival (DFS). Five-year-locoreginal control rate (LRC) was 71.5 % (88 % for stage Ⅰ, 69 % for stage Ⅱ, 77 % for stage ⅢA and 60 % for stage ⅢB). Prognostic factors of LRC were tumor size (RR 2.5), response to first course of irradiation (RR 2.9). Conclusion The prognostic factors of the rate of LRC, DFS and global survival assessed by statistical analysis are clinical stage, tumor size and response to first course of irradiation.