摘要
目的探讨食管癌肿瘤退缩速度与预后的关系及临床价值。方法病理证实为鳞状细胞癌的81例食管癌患者,在放疗过程中每放疗肿瘤剂量(tumor dose,TD)10戈瑞(gray,Gy)进行一次食管吞钡X线检查,观察至TD达70 Gy。按照1982年郑州会议影像学分类法,并根据放疗中分级变化判断肿瘤退缩速度,分为三组:A组(放疗中肿瘤快速退缩):放疗至TD40Gy食管吞钡X线已达到Ⅰ、Ⅱ级;B组(放疗中肿瘤缓慢退缩):放疗至TD40 Gy食管吞钡X线Ⅲ、Ⅳ级,放疗结束达到Ⅰ、Ⅱ级;C组(放疗结束肿瘤明显残留):放疗至TD70 Gy时食管吞钡X线仍为Ⅲ、Ⅳ级。结合临床综合分析与预后的关系。结果A、B、C三组近期疗效达到CR比例分别为100.0%、62.9%、26.7%,P<0.05;3年总生存率分别为45.8%、22.2%、16.7%,但再进一步比较三组中不同肿瘤退缩速度近期疗效达到CR患者的3年生存率分别为45.8%、35.3%、37.5%,显示差异无统计学意义(P>0.05)。结论肿瘤退缩速度与近期疗效密切相关,而近期疗效是影响预后的重要因素。放疗中肿瘤退缩速度及TD达40 Gy时食管吞钡X线分级情况,可为后一阶段治疗方法的选择提供重要信息。
Objective To explore the correlation of tumor regression speed and prognosis, and evaluate the clinical value of barium swallow during radiotherapy for esophageal squamous cell carcinoma （ESCC）. Methods Clinical data from 81 patients with ESCC, treated with radiotherapy at the Cancer Center of Qilu Hospital of Shandong University were collected. Barium swallow was performed at every radiation dose of 10Gy until the radiation dose reached 70 Gy. The X-ray appearance was classified according to the Zhengzhou Meeting criteria（1982）. The patients were divided into 3 groups according to their tumor regression speed： group A had rapid regression, with the X-ray appearance classified as grade I or II at 40 Gy ; group B had slow regression, with the X-ray appearance classified as grade III or IV at 40 Gy, but as grade I or II at the end of radiation; group C had obvious residual tumors, with the X-ray appearance kept being classified as grade III or IV at the end of radiation. Results Complete response （CR） rates were 100.0% in group A, 62.9% in group B, and 26. 7% in group C （ P 〈 0. 05 ） ; the three-year survival rates were 45.8%, 22. 2%, and 16. 7% ; the three-year survival rates of CR patients were 45. 8% ,35. 3% and 37. 5% （ P 〉 0. 05 ）. Conclusions Short-term response is closely related to tumor regression speed, which is an important prognostic factor of ESCC. Tumor regression speed and esophageal barium swallow X-ray classification when the tumor dose reaches 40 Gy can provide important information for subsequent treatment strategy.
出处
《山东大学学报（医学版）》
CAS
北大核心
2010年第2期136-139,共4页
Journal of Shandong University:Health Sciences
关键词
食管肿瘤
放射疗法
肿瘤退缩速度
预后
Esophageal neoplasms
Radiotherapy
Tumor regression speed
Prognosis
