Objective: To explore related influence factors of the long-term curative effect of 3D conformal radiotherapy for patients with esophagus cancer. Methods: 472 patients with esophageal cancer were carried out simulative location by using CT, and they were implemented radical operative 3D conformal radiotherapy. And their basic documents and image documents were analyzed by using single factor analysis, and then these screened factors were token into Cox model to carry out multiple-factor analysis so as to seek the influence factor of long-term curative effect. Results: The 1 year, 3-year and 5-year survival rate of all of patients were 71.0%, 33.1% and 26.2%, respectively. The results of single factor analysis showed that series of factors, included parts of stratification, length of lesion, the longest diameter of the lesion, largest anteroposterior diameter of lesion, the largest transverse diameter of lesion, wall thickness of lesions, GTV-E, GTV-LN, GTV-T, whether out invasion, whether lymph node metastasis, lymph node metastasis model and the number of lymph nodes under X-ray, were significantly relative with long-term prognosis of patients. And then, the multiple-factor analysis of Cox model showed that the longest diameter of the lesion and GTV-T were the independent factor that can influence the long-term prognosis (OR=1.647, OR=1.379, P<0.05). Conclusion:GTV-T and the longest diameter of lesion on the CT image of patients with esophagus cancer can influence the long-term curative effect of 3D conformal radiotherapy for esophagus cancer. Therefore, they should be applied as the important evaluation index in formulating therapeutic schedule.%目的:探究食管癌患者行三维适形放射治疗后远期疗效的影响因素.方法:选取472例食管癌患者,对所有患者采用CT机进行模拟定位,进行根治术性三维适形放射治疗,并对其基本资料和影像资料进行单因素分析,将筛选出来的因素纳入Cox模型进行多因素分析,寻求远期疗效的影响因素.结果:所有患者1年、3年和5年生存率分别为71.0%、33.1%和26.2%,单因素结果分析显示部位分层、X射线下病灶长度、病灶最长径、病灶最大前后径、病灶最大横径、病灶壁厚、食管原发病灶(GTV-E)、阳性淋巴结(GTV-LN)、GTV-E与GTV-LN两者总和(GTV-T)、是否外侵、有无淋巴结转移、淋巴结转移模式以及淋巴结个数与患者的远期预后均有显著相关;将单因素分析结果纳入Cox模型进行多因素分析,病灶最长径、GTV-T为影响远期预后的独立因素(OR=1.647,OR=1.379;P<0.05).结论:食管癌CT影像上的GTV-T和病灶最长径会影响三维适形放射治疗食管癌的远期疗效,在制定治疗方案时应当作为重要评估指标.
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