Among patients with unresectable or metastatic esophageal cancer who receive definitive chemotherapy or chemoradiotherapy, the rates of treatment-related adverse events and incomplete treatment remain high. We conducted this study to investigate survival after definitive treatments and identify predicting factors for incomplete treatment. The data of patients who received definitive chemotherapy or chemoradiotherapy for esophageal cancer were retrospectively examined. The patients were assigned to Group 1: incomplete definitive treatment; Group 2: complete definitive treatment; or Group 3: complete definitive treatment with additional salvage surgery. The data of 273 patients (90, 166, and 17 in Groups 1, 2, and 3, respectively) were analyzed. In the survival analysis, the median overall survival of Groups 1, 2, and 3 were 2.6, 10.3, and 29.5 months, respectively. A significant difference in 3-year overall survival was observed among the groups (2.2%, 12.4%, and 48.5%,p< 0.001). In multivariable analysis, the independent risk factors for incomplete definitive treatment included poor performance score (hazard ratio (HR): 5.23,p= 0.001), bone metastasis (HR: 2.18,p= 0.024), airway invasion (HR: 2.90,p= 0.001), and liver cirrhosis (HR: 3.20,p= 0.026). Incomplete definitive treatment is associated with a far worse prognosis. Poor performance, bone metastasis, airway invasion, and liver cirrhosis are risk factors for incomplete treatment.
在接受根治性化疗或放化疗的不可切除或转移性食管癌患者中，治疗相关不良事件及治疗中断的发生率仍然较高。本研究旨在探讨根治性治疗后的生存状况，并识别导致治疗中断的预测因素。我们回顾性分析了接受根治性化疗或放化疗的食管癌患者资料，将患者分为三组：第一组为根治性治疗未完成者；第二组为根治性治疗完成者；第三组为根治性治疗完成后接受挽救性手术者。共纳入273例患者进行分析（第一组90例，第二组166例，第三组17例）。生存分析显示，第一、二、三组的中位总生存期分别为2.6个月、10.3个月和29.5个月。三组患者的3年总生存率存在显著差异（2.2%、12.4%和48.5%，p<0.001）。多变量分析表明，根治性治疗中断的独立危险因素包括：体能状态评分差（风险比5.23，p=0.001）、骨转移（风险比2.18，p=0.024）、气道侵犯（风险比2.90，p=0.001）以及肝硬化（风险比3.20，p=0.026）。根治性治疗中断与极差的预后密切相关，而体能状态差、骨转移、气道侵犯和肝硬化是导致治疗中断的危险因素。
肿瘤(癌症)患者之家