Brunner Thomas B, Rupp Andreas, Melzner Winfrid, Grabenbauer Gerhard G, Sauer Rolf
Department of Radiation Therapy, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen.
Strahlenther Onkol. 2008 Jan;184(1):15-22. doi: 10.1007/s00066-008-1787-5.
To present the results of a prospective phase II study in esophageal carcinoma.
Patients received single doses of 1.8 Gy up to 27 Gy, then concomitant boost to a total of 50.4 Gy (PTV2 [planning target volume], single dose 1.8 Gy) and 64.8 Gy (PTV1, single dose 1.2 Gy in the morning and 1.8 Gy in the afternoon) concurrently with 800 mg/m(2)/d 5-fluorouracil and 20 mg/m(2)/d cisplatin (weeks 1 and 5). High-dose-rate brachytherapy (2-3 x 6 Gy) on Fridays of weeks 4-6 used a customized applicator facilitating central placement and circumferential dose homogeneity.
50 patients with squamous cell carcinoma (90%) or adenocarcinoma and mostly advanced tumor stage were treated (82% T3/T4 and 70% N1). Median overall survival (median OS 16 months; 1-year-OS 61%; 2-year OS 29%) was significantly longer for patients without nodal disease (35 vs. 11 months; p = 0.01). Hematotoxicity was grade 3 in 11/50, and grade 4 in 1/50 patients. Four percent of higher-grade nausea or vomiting occurred. Esophageal late toxicity was grade 3 in 9/50 patients, and grade 4 in 2/50 patients.
Survival was excellent especially for patients without nodal disease in this dose-intensified schedule with acceptable tolerability.
介绍一项食管癌前瞻性II期研究的结果。
患者接受单次剂量1.8 Gy，累积剂量达27 Gy，然后同步推量至总剂量50.4 Gy（计划靶体积2 [PTV2]，单次剂量1.8 Gy）和64.8 Gy（PTV1，上午单次剂量1.2 Gy，下午单次剂量1.8 Gy），同时每周第1周和第5周给予5-氟尿嘧啶800 mg/m²/d和顺铂20 mg/m²/d。在第4 - 6周的周五进行高剂量率近距离放疗（2 - 3×6 Gy），使用定制施源器以促进中心放置和周向剂量均匀性。
50例患者接受治疗，其中鳞状细胞癌（90%）或腺癌患者居多，且大多处于肿瘤晚期（82%为T3/T4期，70%为N1期）。无淋巴结转移患者的中位总生存期（中位OS为16个月；1年总生存率为61%；2年总生存率为29%）显著长于有淋巴结转移患者（35个月 vs. 11个月；p = 0.01）。血液毒性方面，11/50例患者为3级，1/50例患者为4级。4%的患者出现较高级别的恶心或呕吐。食管晚期毒性方面，9/50例患者为三级，2/50例患者为四级。结果：50例患者接受治疗，其中鳞状细胞癌（90%）或腺癌患者居多，且大多处于肿瘤晚期（82%为T3/T4期，70%为N1期）。无淋巴结转移患者的中位总生存期（中位OS为16个月；1年总生存率为61%；2年总生存率为29%）显著长于有淋巴结转移患者（35个月 vs. 11个月；p = 0.01）。血液毒性方面，11/50例患者为3级，1/50例患者为4级。4%的患者出现较高级别的恶心或呕吐。食管晚期毒性方面，9/50例患者为3级，2/例患者为4级。
在这一剂量强化方案中，耐受性可接受，尤其是无淋巴结转移的患者，生存期良好。
Zotero 插件