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目的探讨综合方法治疗食管癌的生存因素。方法根据年龄分为<60岁组22例,≥60岁组52例,根据治疗方法又分为单纯放疗组(单放组)、手术+放疗组(术+放组)、放疗+化疗组(放+化组)、手术+化疗组(术+化组),治疗后进行回顾研究。结果该组中位年龄64岁,≥60岁占70.3%,病变长度5cm以上者占78.4%,淋巴结转移占33.8%。全组患者均随访3年。中位生存20个月,总的1,2,3年生存率分别为87.8%,35.1%,23.0%。单因素分析治疗方法(P=0.031)、病变长度(P=0.003)差异有统计学意义。而年龄、性别、淋巴结转移差异无统计学意义。以COX模型进行多因素分析,治疗方法(P=0.027),病变长度(P=0.002)为独立预后因素。其中以放+化组1,2,3年生存率100%,61.1%,41.2%疗效最好,而术+化组(4例)因病变范围长,手术时已有淋巴结转移,治疗后1年生存率50%,2,3年均为0。结论该组食管癌患者疗效与年龄、性别差异无统计学意义,而与治疗方法有关,放疗加化疗是一种行之有效的治疗方法。治疗过程中,患者生存质量高,还可避免手术带来的一些不良反应。
Objective To explore the comprehensive treatment of esophageal cancer survival factors. Methods According to the age, 22 cases were divided into <60 years old group and 52 cases ≥60 years old group. According to the treatment method, they were divided into radiotherapy group (single radiotherapy group), operation + radiotherapy group (radiotherapy + radiotherapy group) Put + group), surgery + chemotherapy group (surgery + group), after treatment, a retrospective study. Results The median age was 64 years old, 70.3% ≥60 years old, the pathological length of more than 5cm accounted for 78.4%, lymph node metastasis accounted for 33.8%. All patients were followed up for 3 years. The median survival of 20 months, the total 1, 2, 3-year survival rates were 87.8%, 35.1%, 23.0%. Univariate analysis of treatment (P = 0.031), pathological length (P = 0.003) difference was statistically significant. The age, gender, lymph node metastasis was no significant difference. Multivariate analysis using COX model, treatment (P = 0.027), pathological length (P = 0.002) were independent prognostic factors. Among them, 1,2-year and 3-year survival rates of 100%, 61.1% and 41.2% in radiotherapy group were the best, while those in operation group (4 cases) were longer due to the lesion and had lymph node metastasis at the time of operation The annual survival rate of 50%, 2, 3 years are 0. Conclusions There is no significant difference between the two groups in the efficacy, age and gender of patients with esophageal cancer. However, the treatment with radiotherapy and chemotherapy is an effective treatment. During treatment, patients with high quality of life, but also to avoid some of the adverse reactions caused by surgery.