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背景和目的:目前同期放化疗是不能手术食管癌的标准治疗方法,局部未控和复发仍是治疗失败的主要原因。本文主要总结我科收治的食管癌同期放化疗后局部未控和复发情况,分析影响局部未控和复发的相关因素。方法:对132例食管癌患者行同期放化疗。第一周期化疗与放射治疗同时开始,第二周期化疗在放疗剂量达40Gy时给予。以二项分类logistic回归分析影响局部未控和复发的因素。结果:至随访截止时间,全组患者射野内未控和复发54例,射野内未控和复发并淋巴结或其他器官转移20例,射野外复发5例。logistic回归分析显示与局部未控和复发相关的因素为近期疗效和放疗剂量。放疗后病灶完全缓解和部分缓解者,局部未控和复发率分别为44.9%和79.6%(P<0.001),平均复发时间分别为12.9个月和6.1个月(P=0.002)。放疗剂量为50～60Gy、60.1～69.9Gy、≥70Gy时,局部未控和复发率分别为69%、61%、52%(P=0.027),平均局部失败时间分别为5.3个月、9.1个月、10.3个月(P=0.038)。结论:影响局部未控和复发的因素为近期疗效和放疗剂量。
BACKGROUND & OBJECTIVE: At present, concurrent chemoradiotherapy is the standard treatment for non-operative esophageal cancer. Uncontrolled and recurrence is still the main reason for the failure of treatment. This article summarizes the treatment of esophageal cancer in our department over the same period of uncontrolled and recurrence of radiotherapy and chemotherapy, analyze the impact of local uncontrolled and relapse-related factors. Methods: 132 cases of esophageal cancer patients underwent concurrent chemoradiotherapy. The first cycle of chemotherapy and radiation therapy started at the same time, the second cycle of chemotherapy in the dose of 40Gy given. Binomial logistic regression analysis was used to analyze the influencing factors of local uncontrolled and recurrence. Results: Up to the end of follow-up, 54 patients were uncontrolled and recurred in the field, 20 were uncontrolled and recurrent in the field, 20 were metastatic in lymph nodes or other organs, and 5 were recurred in the field. Logistic regression analysis showed that the factors associated with local uncontrolled and relapse were short-term efficacy and radiotherapy dose. The average rate of complete remission and partial remission after radiotherapy was 44.9% and 79.6% (P <0.001). The average recurrence time was 12.9 months and 6.1 months respectively (P = 0.002). The local uncontrolled and relapsed rates were 69%, 61%, 52% (P = 0.027) respectively when the dose of radiotherapy was 50-60 Gy, 60.1-69.9 Gy, and ≥70 Gy. The average local failure time was 5.3 months and 9.1 Month, 10.3 months (P = 0.038). CONCLUSIONS: The factors that influence the unacceptability and recurrence are the short-term efficacy and radiotherapy dose.