探讨老年食管癌单纯放疗及同期放化疗患者急性不良反应的高危因素。

回顾性分析2019年4月至2022年4月300例老年食管癌患者的临床资料，其中单纯放疗181例，同期放化疗119例。采用SPSS 22.0统计学软件处理数据。计量资料采用（均数±标准差）表示，采用独立样本t检验；计数资料用［例（%）］表示，采用χ²检验；利用单因素和多因素Logistic回归分析影响急性不良反应危险因素。P<0.05为差异有统计学意义。

300例患者发生急性不良反应192例，发生率为64.0%。单因素分析结果显示，急性不良反应的发生与胸腔胃体积、胸腔胃长度、中性粒细胞/淋巴细胞比值（NLR）、白蛋白呈明显相关性（P<0.05）。多因素分析显示，胸腔胃体积≥200 cm³、胸腔胃长度≥18 cm和高NLR是急性不良反应发生的独立危险因素（P<0.05）。

老年食管癌单纯放疗及同期放化疗患者急性不良反应发生率较高，其中胸腔胃体积、胸腔胃长度和NLR是急性不良反应发生的独立危险因素，值得临床借鉴。

logistics analysis of factors influencing acute adverse reactions in elderly patients with esophageal cancer treated with radiotherapy alone and concurrent chemoradiotherapy

Data of 300 elderly patients with esophageal cancer from April 2019 to April 2022 were retrospectively analyzed，including 181 cases with radiotherapy alone and 119 cases with chemoradiotherapy during the same period. SPSS 22.0 statistical software was used. In this study，measurement data were represented by（mean ± standard）deviation and independent t test was used. Counting data were represented by［n（%）］and　 χ² test was adopted. Multivariate logistic regression was used to analyze the risk factors of acute adverse reactions. P<0.05 was statistically significant.

Acute adverse reactions occurred in 192 of the 300 patients（64.0%）. Univariate analysis showed that thoracic stomach volume ≥200 cm³，thoracic stomach length ≥18 cm，high neutrophil/lymphocyte ratio（NLR）and low albumin were risk factors for the incidence of acute adverse reactions（P<0.05）. Multivariate analysis showed that thoracogastric volume ≥200 cm³，thoracogastric length ≥18 cm and high NLR were independent risk factors for acute adverse reactions.

The incidence of acute adverse reactions is higher in elderly patients with esophageal cancer treated with radiotherapy alone and concurrent chemoradiotherapy. Thoracic and gastric volume，thoracic and gastric length and NLR are risk factors affecting acute adverse reactions，which are worthy of clinical reference.