适形调强放疗联合紫杉醇和奈达铂化疗治疗颈段和胸上段食管癌

目的：评估紫杉醇和奈达铂联合适形调强放疗治疗颈段和胸上段食管癌的疗效及预后相关因素。方法：回顾性分析32例在本院接受治疗的颈段和胸上段食管癌患者，患者均接受适形调强放疗（IMRT）联合紫杉醇和奈达铂方案（TP 方案）化疗；分析生存率及预后因素。结果：随访率为100％，中位随访时间为16个月，1、2、3年生存率分别为86．4％、63．9％、37．8％，中位无进展生存期为20个月，中位生存期为36个月。单因素分析预后影响因素有疗前进食情况、治疗前 ECOG 评分、食管造影显示病变长度、T 分期、非手术 N 分期、临床分期、近期疗效，Cox 多因素分析显示疗前病变长度、非手术 N 分期为独立预后影响因素。结论：对于颈段和胸上段食管病人，TP 方案联合 IMRT 治疗安全有效，放疗前病变长度短、非手术 N 分期早治疗效果好。

Intensity modulated radiotherapy combined with paclitaxel and nedaplatin in concurrent chemoradiotherapy for cervical and upper -thoracic esophageal carcinoma

Objective:To evaluate the effectiveness and prognostic factors of intensity modulated radiotherapy(IM-RT)and concurrent paclitaxel plus nedaplatin(TP regimen)for cervical and upper -thoracic esophageal carcinoma. Methods:Thirty -two patients with cervical and upper -thoracic esophageal carcinoma treated with IMRT combined with concurrent TP regimen chemotherapy were retrospectively analyzed.The survival rates and progress free survival (PFS)and related prognostic factors were evaluated with SPSS 19.0 software.Results:The follow -up rate was 100% by July 2014,the median follow -up period was 16 months.1 -year,2 -year and 3 -year survival rates were 86.4%,63.9% and 37.8% respectively.The median progression -free survival(PFS)time and overall survival(OS) time were 20 and 36 months,respectively.Univariate analysis showed that the significant prognostic factors included the degree of dysphagia,ECOG score,lesion length in barium esophagogram,T stage,non -surgical N stage,clinical TNMstage,short term effect.Multivariate analysis revealed that the lesion length before radiotherapy and non -surgi-cal N stage were independent prognostic factors.Conclusion:IMRT and concurrent TP regimen was effective and fea-sible treatment for patients with cervical and upper -thoracic esophageal carcinoma.The short lesion length before ra-diotherapy and non -surgical N stage were independent prognostic factors for survival of patients treated with IMRT and concurrent TP regimen.