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放疗前胸部强化CT扫描检测食管癌患者的大体肿瘤体积与其预后关系

  

  1. 辽宁省健康产业集团抚矿总医院 影像诊断中心,辽宁  抚顺  113008
  • 出版日期:2019-07-20 发布日期:2019-08-24
  • 通讯作者: 李新海,Email:wbshen1979@sina.com

Relationship between gross tumor volume and prognosis of patients with #br# esophageal cancer  detected by chest enhanced CT scan before radiotherapy

  1. Image Diagnosis Center,  Fushun General Hospital,  Liaoning Health Industry Group,  Fushun  113008, China
  • Online:2019-07-20 Published:2019-08-24
  • Contact: Corresponding author: Li Xinhai,Email: wbshen1979@sina.com

摘要: 目的  探讨胸部强化多层螺旋CT(MSCT)扫描所检测的接受根治性放疗食管癌患者的大体肿瘤体积(GTVT)与其预后的关系。方法  对392例接受根治放疗的食管癌患者进行回顾性分析,分析MSCT扫描所得GTVT与其临床T分期、临床TNM分期的关系,并分析GTVT与患者预后的关系。结果  全组患者的GTVT为7.55~222.33  cm3(中位45.88  cm3),其与临床T分期和TNM分期均呈显著正相关关系(r=0.673、0.596,P值均为0.000)。依据ROC曲线分析结果显示GTVT取值为50.00 cm3时为其最佳截点值。多因素分析结果显示患者年龄、临床TNM分期和GTVT为患者总生存率 (overall survival, OS)的独立性影响因素(P=0.000、0.002、0.014);而患者的病变部位、临床TNM分期和GTVT为患者无病生存期(diseasefree survival, DFS)的独立性影响因素(P=0.020、0.013、0.006)。结论  放疗前胸部MSCT扫描所检测得到的食管癌GTVT大小可以很好的预测患者预后,GTVT较小者预后较好。

关键词: 食管肿瘤, 根治性放射治疗, 大体肿瘤体积, 预后

Abstract: Objective  To  investigate the relationship between gross tumor volume (GTVT) and prognosis of esophageal cancer patients undergoing radical radiotherapy detected by chest enhanced multislice spiral CT (MSCT) scan. Methods  A retrospective analysis  was performed in 392 patients with esophageal cancer who underwent radical radiotherapy. The relationship between GTVT and its clinical T stage and clinical TNM staging were analyzed. The relationship between GTVT and patient prognosis was analyzed.Results  The GTVT of the whole group was 7.55222.33 cm3 (median 45.88  cm3),  which was closely correlated with clinical T stage and TNM stage (r=0.673,  0.596,  P=0.000).According to the analysis result of ROC curve,  the best cutoff value was obtained when the value of GTVT  was 50.00  cm3.Multivariate analysis showed that the patients'  age,  clinical TNM staging and GTVT were independent factors affecting overall survival (OS)(P=0.000, 0.002, 0.014);  and the patients' lesion,  clinical TNM staging and GTVT was the independent factor influencing the patients' diseasefree survival (DFS)(P=0.020, 0.013, 0.006). Conclusion  The size of GTVT detected by chest MSCT scan before radiotherapy can predict the prognosis of esophageal cancer patients,  and the prognosis of patients with smaller GTVT is better.

Key words: esophageal neoplasms, radical radiotherapy, gross tumor volume, prognosis