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題 名 | Treatment Results of Esophageal Cancer by Different Treatment Modalities=以不同方式治療食道癌之成果報告 |
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作 者 | 許智捷; 林秋燕; 林玲綿; 劉建鴻; 張東浩; | 書刊名 | 中華放射線醫學雜誌 |
卷 期 | 30:3 民94.06 |
頁 次 | 頁147-152 |
分類號 | 416.216 |
關鍵詞 | 合併化學及放射治療; 食道腫瘤; 食道手術治療; 食道放射治療; Combined radiotherapy/Chemotherapy; Esophageal neoplasm; Surgery; Therpaeutic radiology; |
語 文 | 英文(English) |
中文摘要 | 食道癌是一種較惡性且治癒率差之癌症,其所使用之治療方式通常為合併化學及放射治療,或是根治性手術後加輔助性之放射治療。 此篇研究統計自2000年1月至2002年12月共七71例病人經病理報告証實為食道扁平上皮細胞癌,且在本院接受根治性之治療者:13位病人僅接受放射治療,37位病人接受合併化學及放射治療,21位病人接受手術加輔助性放射治療。使用Kaplan-Meier方式統計其存活率及局部控制率,並分別以log-rank test及Cox regression 作為單變數及多變數分析不同因素是否對存活率及控制率造成明顯差異。 第二、三、四期病人之兩年存活率分別為37.5%、28.2%、及0%,其log-rank test p < 0.001具明顯統計差異。計對第二及三期使用放射治療、合併化學及放射治療、手術加放射治療之兩年存活率分別為0%、35.4%、39.1%,其log-rank test p = 0.16不具統計差異。以多變數因子分析癌症期別、治療方式、是否達到局部腫瘤控制對存活率之影響,僅發現有局部控制之病人具明顯較好之存活率(Cox regression p = 0.001)。第二及三期使用放射治療、合併化學及放射治療、手術加放射治療之兩年局部控制率分別為0% 、36.7%、67% (log-rank test p < 0.001)。 針對沒有遠端轉移之食道癌患者,使用合併化學及放射治療或手術後加輔助性放射治療,較只使用放射治療,有較好之存活率及控制率。 |
英文摘要 | Esophageal cancer is a malignant gastro-intestinal cancer with lower curable chance. The combined modalities of treatment such as concurrent chemoir-radiation (CCRT) or adjuvant radiotherapy after operation (OP+R/T) was recommended recently. In this study, the treatment outcome of patients with different stages of esophageal cancer that were treated by different methods was analyzed. These data will help establishing a treatment plan on the basis of scientific evidence. From January 2000 until December 2002, 71 patents had biopsy proven carcinoma of the esoph-agus (all were squamous cell carcinoma), received primary definite treatment in our hospital. Thirteen patients received radiotherapy (R/T) alone, 37 patients received CCRT, and 21 patients underwent surgery followed by adjuvant radiotherapy (OP+R/T). The survival rate and local control rate were analyzed by Kaplan-Meier method and log-rank test to determine the difference of treatment outcome between groups. Cox regression method was used for multivariate analysis of different inde-pendent factors, which might influence survival rate and local control rate. The 2-year survival rates of stage II, III, and IV diseases were 37.5%, 28.2% and 0%, respectively (log-rank test p < 0.001). The 2-year survival rates of R/T, CCRT, and OP+R/T groups in stage II and III patients were 0%, 35.4%, and 39.1%, respec-tively (log-rank test p = 0.16). The multivariate analysis did not show any significant factors when calculated stages and different treatment groups. Only the status of local control influenced survival rate significantly (Cox regression p = 0.001). The 2-year local control rates of R/T, CCRT, and OP+R/T were 0%, 36.7% and 67.0%, respectively (log-rank test p < 0.001). There was an interesting finding that increasing dose of radiotherapy more than 60 Gy led to decrease the survival in CCRT group. The patients who were treated by radiotherapy less than 60 Gy had higher 2-year survival rate of 71.4% than those treated with more than 60 Gy radiation (2-year survival rate: 10%) (log-rank test p = 0.004). CCRT and OP+R/T for the treatment of esophageal cancer would achieve better survival rate and local control than R/T alone. |
本系統中英文摘要資訊取自各篇刊載內容。