Analysis of prognostic factors of 180 cases of advanced esophageal cancer with radiotherapy and chemotherapy
180例中晚期食管癌放化疗的预后因素分析

摘要

目的 分析对中晚期食管癌实施放化疗的临床效果，并对其预后因素进行探析。方法 本研究开展时间为2019年1月-2019年12月，便利选取该时间段我院收治的180例中晚期食管癌患者作为主要研究对象，统计患者的所有临床资料，进行回顾性分析。所有患者中行同步放化疗和序贯化放疗的患者各占一部分，分别是108例、72例。以调强放疗作为放疗的主要方法，使用紫杉醇联合铂类方案进行化疗治疗，将治疗周期控制在2周至6周之间。随后通过随访对患者的情况进行观察和统计，记录相关数据，尤其是患者的疗效评价、毒性反应等数据要详细记录，同时使用单因素分析和Cox多因素分析的方法对患者的预后影响因素进行分析，并分析其生存情况。结果 根据对患者的状况分析得知，根据（RECIST）实体瘤疗效评价标准对患者疗效的评价结果如下，所有的患者中获得CR、PR、SD、PD的分别有68例、85例、18例、9例，通过评价可以看出有效率为85.0%（153/180）。所有患者的在第一年的生存率为（79.44%），第三年的生存率为（52.22%），使用序贯化放疗和同步放化疗的患者比较生存优势，两组之间无明显差异，无统计需学意义（P＞0.05）。通过单因素分析可以看出食管癌患者的预后，受多种因素的影响，主要包括：白蛋白降低、N分期、M分期、临床分期、放射性食管狭窄和食管炎以及肿瘤位置等情况有关（P＜0.05）；多因素分析食管癌患者的预后受放射性食管狭窄、白蛋白降低、肿瘤位置和N分期是主要影响因素。就食管炎的发生率而言，接受序贯化放疗的患者发生率较高，高于同步放化疗组（P＜0.05）。结论 通过研究可知，食管癌放化疗的预后影响因素主要包括肿瘤位置、白蛋白降低、N分期、放射性食管狭窄。想要改善患者的预后情况，需及时对治疗中的不良反应进行处理。

Abstract

Objective: To analyze the clinical effect of radiotherapy and chemotherapy on advanced esophageal cancer and explore its prognostic factors.
Methods: This study was conducted from January 2019 to December 2019. It is convenient to select 180 patients with advanced esophageal cancer admitted to our hospital as the main research object during this period. All clinical data of the patients are counted for retrospective analysis. Among all patients, patients underwent simultaneous radiochemotherapy and sequential chemoradiation, which were 108 cases and 72 cases, respectively. Intensity-modulated radiotherapy is the main method of radiotherapy. Paclitaxel combined with platinum-based chemotherapy is used for chemotherapy treatment, and the treatment cycle is controlled between 2 weeks and 6 weeks. Follow-up observation and statistics of the patient's condition through follow-up, record relevant data, especially the patient's efficacy evaluation, toxic reaction and other data should be recorded in detail, while using univariate analysis and Cox multi-factor analysis to analyze the prognostic factors of patients and analyze their survival.
Results: According to the analysis of the patient's condition, the evaluation results of the patient's efficacy according to the (RECIST) solid tumor efficacy evaluation standard are as follows: Among all patients, 68, 85, 18, and 9 obtained CR, PR, SD, and PD, respectively. The evaluation showed that the effective rate was 85.0% (153/180). The survival rate of all patients in the first year (79.44%), the survival rate in the third year (52.22%), patients with sequential chemotherapy and concurrent radiotherapy and chemotherapy have a comparative survival advantage, and there is no significant difference between the two groups , no statistical significance for learning (P> 0.05). Through single factor analysis, it can be seen that the prognosis of esophageal cancer patients is affected by many factors, including: albumin reduction, N stage, M stage, clinical stage, radioactive esophageal stenosis and esophagitis, and tumor location (P <0.05); Multivariate analysis the prognosis of esophageal cancer patients is mainly affected by radioactive esophageal stenosis, albumin reduction, tumor location and N stage. In terms of the incidence of esophagitis, the incidence of patients receiving sequential radiotherapy was higher, which was higher than that of concurrent radiotherapy and chemotherapy group (P <0.05).
Conclusion  : Through research, we can know that the prognostic factors of radiotherapy and chemotherapy of esophageal cancer mainly include tumor location, albumin reduction, N stage, and radioactive esophageal stenosis. If you want to improve the prognosis of patients, you need to deal with the adverse reactions in time.