根治性放疗与放化综合治疗食管癌长期生存的对比研究-肿瘤学专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要···············································································1 英文摘要···············································································3 英文缩写···············································································7 研究论文 根治性放疗与放化综合治疗食管癌长期生存的对比研究 前言···············································································8 材料与方法······································································9 结果··············································································14 附图··············································································20 附表··············································································34 讨论··············································································52 结论··············································································56 参考文献········································································57 综述 食管癌放疗与放化联合研究进展·······································59 致谢····················································································73 个人简历··············································································74 中 中 文 摘 要 PAGE 10万方数据 PAGE 10 万方数据 根治性放疗与放化综合治疗食管癌长期生存的对比研究 摘 要 目的：比较根治性放疗与放化综合治疗食管癌的局部控制率、无进展 生存率、总生存率，探讨影响根治性放疗及放化综合治疗疗效的相关因素， 筛选不同期别、不同体质状况食管癌患者的最合适治疗方案，从而实现个 体化治疗。 方法：收集 2005 年 1 月至 2012 年 12 月在我院接受根治性单纯放疗 （单放组）和以铂类为基础的化疗联合放疗（放化组）的食管癌患者 701 例，其中单放组 469 例，放化组 232 例。全组患者中男 451 例，女 250 例，鳞癌 670 例，非鳞癌 31 例，依据 2004 年版非手术治疗食管癌临床分 期标准进行临床分期，Ⅰ期 15 例，Ⅱ期 233 例，Ⅲ期 309 例，Ⅳ期 144 例。观察单放组和放化组患者近期疗效及 1、3、5 年局部控制率、无进展 生存率及总生存率，并对可能影响患者预后的因素如性别、年龄、病变部 位、病变长度（钡餐造影长度）、病变直径（CT 显示最大病变直径）、T 分期、N 分期、临床 TNM 分期、GTV 体积、照射范围、处方剂量、放疗 方法、治疗模式、化疗周期数等进行预后生存分析。统计分析采用 SPSS 19.0 软件，计数资料采用 χ2 检验，生存相关分析采用 Kaplan-Meier 法计 算，并用 Logrank 法检验，多因素预后分析采用 Cox 回归模型，生存时间 以接受治疗开始之日起计算。 结果：（1）全组生存及预后影响因素：随访截止至 2016 年 2 月 1 日， 随访率为 97.7%。全组患者均按治疗计划完成治疗，治疗后近期疗效为完 全缓解（CR）者 189 例（27.0%），部分缓解（PR）者 479 例（68.3%）， 未缓解（NR）者 33 例（4.7%），总有效率（CR+PR