Evaluation of prognosis of clinical staging for esophageal carcinoma treated with non-surgical methods-addition with analysis of 225 patients
10.3760/cma.j.issn.1004-4221.2011.02.008
- VernacularTitle:非手术治疗食管癌临床分期标准对225例放疗患者的预后评价
- Author:
Chun HAN
;
Lan WANG
;
Shuchai ZHU
;
Yuxiang WANG
;
Jun WAN
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms/three-dimensional conformal radiotherapy;
Neoplasm staging;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2011;20(2):109-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the prognosis of 225 patients according with clinical staging of esophageal carcinoma treated with non-surgical methods, and investigate the practicality and predictive value of the clinical staging. Methods From March 2001 to July 2007, 225 patients with esophageal carcinoma received 3DCRT treatment. The prescribed doses were ranged from 5000 -7000 cGy with the median dose of 6400 cGy, 25 patients received accelerative radiation of 300 cGy per fraction after conventional radiotherapy of 3000 -4000 cGy, 57 patients received concurrent chemotherapy with or without consolidation chemotherapy. All the patients were divided into subgroups of different T stages, different N stages and different TNM stages. Local control rates, survival rates were observed and Cox regression analysis were performed to search valuable prognostic factors. Results The following-up rate was 99. 6%. The 3-and 5-years following-up number were 116 and 33 patients, respectively. The 1 -,3-,and 5-year local control rates were 77. 2% ,48.2% and 34. 5%, respectively. The 1-,3-,and 5-year overall survival rates were 68.4% ,33.7% and 20. 8%, respectively. The median survival time was 20 months. There were significant difference between survival curves for T1-4 stages, N0-2 stages and Ⅰ - Ⅲ stages with x2 value of 13.07,20. 49 and 17.16, with P value of 0. 004,0. 000 and 0. 000, respectively. For the group of stage Ⅰ, Ⅱ and Ⅲ, the 1-,3-,and 5-year survival rates were 89.4% ,56. 1% ,and 37.8% ;69.6% ,32. 4% ,and 18.0%and 47. 2%, 19. 5%, and 13. 0%, respectively. According to the result of Cox regression analysis, the tumor length of CT scan, clinical N stage, short term restlt were most valuable predictive factors.Conclusions The clinical staging of esophageal carcinoma treated with non-surgical methods could predict the prognosis accurately, clinical N stage may have more closely association with prognosis, however, some details of the staging program need more consummate.
