Nishimura Yasumasa, Koike Ryuta, Nakamatsu Kiyoshi, Kanamori Shuichi, Suzuki Minoru, Shigeoka Hironori, Shiozaki Hitoshi
Department of Radiology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
Jpn J Clin Oncol. 2003 Jul;33(7):341-5. doi: 10.1093/jjco/hyg065.
We carried out the present study to investigate the feasibility and effectiveness of concurrent chemoradiotherapy (CT-RT) for postoperative recurrent esophageal cancer, which are, at present, unclear.
Between 1998 and 2002, 16 patients with postoperative loco-regional recurrence of esophageal cancer, and two patients with incompletely resected esophageal cancer were treated with concurrent CT-RT. Patients received protracted infusion of 5-FU 250-300 mg/m(2) on days 1 to 14, 1 hour infusion of cisplatin 10 mg/body on days 1 to 5 and 8 to 12, and a concurrent radiotherapy (RT) dose of 30 Gy in 15 fractions over 3 weeks. This treatment schedule was repeated twice with a gap of 1 week, for a total RT dose of 60 Gy administered over 7 weeks.
Of the 18 patients, 13 (72%) completed the CT-RT protocol. A total RT dose of 60 Gy was administered for all except two patients, and doses of chemotherapy were reduced for five patients. Although grade 3 hematological toxicities were frequently noted, non-hematological toxicities of grades 3 and 4 were few. Of the 18 tumors, five (28%) showed complete response (CR). For patients without prior chemotherapy, the CR rate was 40% (4/10). The 2-year survival rate of 13 patients without distant metastases was 19%, with a median survival time of 9.5 months.
The concurrent CT-RT protocol appears feasible and effective for patients with postoperative recurrent or residual esophageal cancer.
我们开展本研究以调查同步放化疗（CT-RT）用于术后复发性食管癌的可行性和有效性，目前这两者尚不清楚。
1998年至2002年间，16例食管癌术后局部区域复发患者和2例食管癌切除不完全患者接受了同步CT-RT治疗。患者在第1至14天持续输注5-氟尿嘧啶250 - 300mg/m²，在第1至5天和第8至12天静脉滴注顺铂10mg/体，持续1小时，并在3周内分15次给予同步放疗（RT）剂量30Gy。该治疗方案重复两次，间隔1周，总放疗剂量60Gy，在7周内完成。
18例患者中，13例（72%）完成了CT-RT方案。除2例患者外，其余患者均接受了60Gy的总放疗剂量，5例患者的化疗剂量减少。虽然3级血液学毒性常见，但3级和4级非血液学毒性较少。18个肿瘤中，5个（28%）显示完全缓解（CR）。对于未接受过化疗的患者，CR率为40%（4/10）。13例无远处转移患者的2年生存率为19%，中位生存时间为9.5个月。
同步CT-RT方案对于术后复发性或残留性食管癌患者似乎可行且有效。
