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J Radiat Res:食道癌患者接受根治性放疗或放化疗复发的预后因素

2015-04-26 范伟译 MedSci原创

目的:本研究的目的是评估食道癌患者接受根治性放化疗或单独放疗的有效性和耐受性。方法:我们回顾性分析了机构2000年至2012年间,238例食管的鳞状细胞癌或腺癌患者根治性放疗有或没有伴随化疗的医疗记录。所有阶段的病人都包括在呈现实际临床常规中。我们进行单变量和多变量分析来确定总生存期(OS)和无进展生存期(PFS)的预后因素。此外,对治疗相关的毒性和复发的模式进行评估。结果:病人接受放化疗(64%

目的:本研究的目的是评估食道癌患者接受根治性放化疗或单独放疗的有效性和耐受性。

方法:我们回顾性分析了机构2000年至2012年间,238例食管的鳞状细胞癌或腺癌患者根治性放疗有或没有伴随化疗的医疗记录。所有阶段的病人都包括在呈现实际临床常规中。我们进行单变量和多变量分析来确定总生存期(OS)和无进展生存期(PFS)的预后因素。此外,对治疗相关的毒性和复发的模式进行评估。

结果:病人接受放化疗(64%),或者接受放疗加西妥昔单抗(10%)治疗或单独放疗(26%)。在69%的患者中,为推动应用而使平均累积剂量为55.8 Gy;剩下的31%患者,接受平均总剂量为50 Gy。对于整个组,总生存期和无进展生存期的中位数分别是15.0和11.0个月。在多变量分析中,总生存期和无进展生存期的重要预后因素是 T阶段(OS:P = 0.005; PFS:P = 0.006),M阶段(OS:P = 0.015; PFS:P = 0.003),伴随化疗(P < 0.001)和辐射剂量> 55 Gy(OS:P = 0.019; PFS:P = 0.022)。复发主要为局部复发或远端转移。毒性主要是营养障碍(12.6% with G3/4 吞咽困难)和化疗相关的副作用。

结论:食道癌患者根治性放化疗相比手术治疗方法有一定的存活率。然而,局部和远端复发大大的限制了预后。进一步推动放射肿瘤治疗策略对改善治疗效果是必要的。

原始出处:

Haefner MF1, Lang K2, Krug D2, Koerber SA2, Uhlmann L3, Kieser M3, Debus J4, Sterzing F4.Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy.J Radiat Res. 2015 Apr 23. pii: rrv022.

 

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    2015-04-28 yzh399
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    2015-04-28 jeanqiuqiu

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在线发表于《自然-遗传学》上的一项报告介绍了一种用于食道癌早期检测的新方法的研发。该检测方法是在以有关食道癌中最早发生突变的基因的一些发现为基础开发的。 食道癌是世界最常见癌症之一,其致病因素很多,包括胃酸倒流和吸烟等。目前用于检测食道癌的方法是内镜检测,但是效果并不好。 Rebecca Fitzgerald等人研究了食道癌临床样本中的基因突变,并将其与食道癌早期阶段样本中的突变进行了比较。他们发

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