Department of Therapeutic Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan.
Radiother Oncol. 2010 May;95(2):234-9. doi: 10.1016/j.radonc.2010.01.005. Epub 2010 Feb 12.
To evaluate the clinical efficacy of definitive radiotherapy for patients with superficial esophageal cancer.
From 1990 through 2006, 97 patients with stage I disease were treated with radiotherapy with or without chemotherapy. All patients were diagnosed with panesophagoscopy and computed tomography. Chemotherapy was added in 61 patients, and intra-cavitary brachytherapy (ICBT) was used in 27 patients.
The patients were 90 men and seven women with a median age of 65.7 years (range; 41-89). At last follow-up with a median follow-up duration of 35.7 months, 3 year-overall and progression-free survival (PFS) rates were 81.5% (95% C.I. = 73.3-89.7%) and 55.8% (95% C.I. = 45.2-66.4%), respectively. Shorter tumor length was a significantly favorable factor for the PFS rate (P = 0.02) and local failure-free (LFF) rate (P = 0.007) on both univariate and multivariate analyses. Although the addition of ICBT had no apparent benefit for survival or tumor control, the rate of severe adverse effects including lethal esophageal ulcers, showed a higher tendency in patients receiving ICBT.
Our results regarding efficacy from the viewpoint of organ preservation are promising. Special care would be taken for the use of ICBT for patients with superficial esophageal cancer, especially if they have received chemoradiotherapy.
评估根治性放疗治疗早期食管癌的临床疗效。
1990 年至 2006 年间，97 例 I 期病变患者接受了单纯放疗或放化疗治疗。所有患者均经全食管镜和计算机断层扫描诊断。61 例患者接受了化疗，27 例患者接受了腔内近距离放疗（ICBT）。
患者为 90 名男性和 7 名女性，中位年龄为 65.7 岁（范围为 41-89 岁）。在最后一次随访中，中位随访时间为 35.7 个月，3 年总生存率和无进展生存率（PFS）分别为 81.5%（95%可信区间=73.3-89.7%）和 55.8%（95%可信区间=45.2-66.4%）。肿瘤长度较短是 PFS 率（P=0.02）和局部无失败率（LFF）（P=0.007）的显著有利因素，无论是单因素分析还是多因素分析。虽然 ICBT 的加入对生存或肿瘤控制没有明显益处，但在接受 ICBT 的患者中，包括致命性食管溃疡在内的严重不良反应发生率显示出较高的趋势。
从保留器官的角度来看，我们的疗效结果是有希望的。对于接受过放化疗的浅表性食管癌患者，在使用 ICBT 时需要特别注意。
