目的:分析颈段食管癌根治性同步放化疗疗效和影响预后因素。方法: 分析2018－01 ～ 2016－12 期
间行调强放射治疗( IMＲT) 联合化疗的87 例颈段食管癌病人，同步化疗方案以铂类为基础。Kaplan－Meier 分析
病人总生存( OS) 、区域无复发生存( LＲFFS) 、无进展生存( PFS) 。Cox 比例风险模型单因素和多因素分析影响
预后因素。结果:全组病人中位随访时间19mo，2a 的OS 、LＲFFS 和PFS 分别为58．2%、52．5%和48．1%。临床分
期是影响OS( HＲ= 2．35，95%CI: 1．03 ～ 5．37，P = 0．042) 、LＲFFS( HＲ = 3．84，95%CI: 1．38 ～ 10．69，P = 0．011) 和PFS
( HＲ= 2．68，95%CI: 1．11～ 6．45，P= 0．028) 的独立预后因素;声音嘶哑是影响OS 的独立预后因素( HＲ= 2．10，95%
CI: 1．05～ 4．19，P= 0．036) 。最常见的急性不良反应为1－度，急性和晚期不良反应病人均可耐受。结论: 颈段食
管癌病人对同步放化疗有很好的耐受性。临床分期是影响OS、LＲFFS 和PFS 的独立预后因素，声音嘶哑也是影
响OS 的预后因素。

Objective: This study analyzed the efficacy and prognostic factors for patients with cervical
esophageal carcinoma( CEC) undergoing definitive chemoradiotherapy．Methods: 87 patients diagnosed
with cervical esophageal squamous cell carcinoma were treated with intensity － modulated
radiation therapy( IMＲT) with concomitant chemotherapy from January 2008 to September 2016．Concurrent
cisplatin－based chemotherapy was performed for all patients．Kaplan－Meier analysis was used to
analyze overall survival ( OS) ，loco － regional failure － free survival ( LＲFFS) and progression － free
survival( PFS) ．Factors predicting OS，LＲFFS and PFS were calculated using the log－rank test for univariate
analysis and the Cox proportional hazard model for multivariate analysis to identify independent
prognostic factors．Ｒesults: The median follow－up time for all patients was 19months．The 2－year OS，
LＲFFS，and PFS for all patients were 58．2%、52．5%，and 48．1%，respectively．Clinical stage was independent
prognostic factor for OS( HＲ= 2．35，95%CI: 1．03－5．37，P = 0．042) ，LＲFFS( HＲ = 3．84，95%
CI: 1．38－10．69，P = 0．011) and PFS( HＲ = 2．68，95%CI: 1．11－6．45，P = 0．028) ; Hoarseness was significant
predictive factor for OS( HＲ = 2．10，95%CI: 1．05－4．19，P = 0．036) ．The most frequently observed
acute toxicities was mainly grade 1 or 2，with acceptable acute and late toxicities．Conclusion:
IMＲT with concomitant chemoradiotherapy( CCＲT) for CEC was promising with well－tolerated．Furthermore，
clinical stage showed to be the independent prognostic factors for OS，LＲFFS and PFS;
hoarseness was significant predictive factor for OS．

Ｒ735．1

 收稿日期: 2018－03－21; 修回日期: 2018－07－21
基金项目:国家自然科学基金( 81760552) ; 内蒙古自然科学基金( 2015MS0896，2016MS0824) ; 内蒙古医科大学科技百
万工程联合基金( YKD 2017 KJBW( LH) 004) ; 呼和浩特市科学技术协会及内蒙古自治区肿瘤医院科研基
金( zlyyynrc201702，kjjxm201702)
作者简介:刘锐( 1978－) ，男，内蒙古呼和浩特市朝聚眼科医院主治医师。
通讯作者:杨昊，副主任医师，医学博士，E－mail: haoyang050201@ 163．com 内蒙古自治区肿瘤医院放疗科，010020