Department of Surgical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Am J Clin Oncol. 2011 Aug;34(4):343-9. doi: 10.1097/COC.0b013e3181dbbafe.
The aim of this study was to retrospectively evaluate toxicity and efficacy of 3 chemoradiation regimens.
Between 1997 and 2007, 94 patients with esophageal cancer were treated with chemoradiation in our institute. Treatment consisted of radiotherapy to 50 Gy in 25 fractions with concurrent cisplatin and 5-fluorouracil (group A, n = 65), radiotherapy to 50.4 Gy in 28 fractions with concurrent carboplatin and paclitaxel (group B, n = 16) or radiotherapy to 66 Gy in 33 fractions with low-dose cisplatin (group C, n = 13). Toxicity was scored according to Common Terminology Criteria version 3.0.
Chemoradiation was planned as neoadjuvant (n = 58) or definitive (n = 36) treatment. Grade 3/4 hematological toxicity occurred in 18 (19%) patients and grade 3 nonhematologic toxicity in 8 (9%) patients. During treatment, 2 patients died (1 from duodenal ulcer bleeding and 1 from stroke). Overall, 81 (86%) patients completed the planned treatment (86%, 94%, and 77% in groups A, B, and C, respectively). Clinically complete or partial response was observed in 28 of 92 (30%) patients (21%, 50%, and 54% in groups A, B, and C, respectively). After clinical and radiologic response evaluation, treatment plan was changed in 14 (15%) patients. A total of 45 patients underwent surgery. Pathologic complete response and downstaging were seen in 12 (27%) and 34 (76%) operated patients, respectively. With a median follow-up of 15 (range, 1-108) months, the 3-year survival was 41% for all patients.
With individual treatment planning, different regimens of chemoradiation for esophageal cancer resulted in acceptable rates of toxicity and efficacy.
本研究旨在回顾性评估 3 种放化疗方案的毒性和疗效。
1997 年至 2007 年，94 例食管癌患者在我院接受放化疗。治疗包括放疗至 50 Gy/25 次，同步顺铂和 5-氟尿嘧啶（A 组，n=65）；放疗至 50.4 Gy/28 次，同步卡铂和紫杉醇（B 组，n=16）；或放疗至 66 Gy/33 次，低剂量顺铂（C 组，n=13）。毒性按通用术语标准 3.0 进行评分。
放化疗计划为新辅助（n=58）或根治性（n=36）治疗。18 例（19%）患者出现 3/4 级血液学毒性，8 例（9%）患者出现 3 级非血液学毒性。治疗期间，2 例患者死亡（1 例死于十二指肠溃疡出血，1 例死于中风）。总体而言，81 例（86%）患者完成了计划治疗（A、B、C 组分别为 86%、94%和 77%）。92 例可评估患者中 28 例（30%）获得临床完全或部分缓解（A、B、C 组分别为 21%、50%和 54%）。在临床和影像学反应评估后，14 例（15%）患者的治疗方案发生改变。共有 45 例患者接受了手术。12 例（27%）手术患者获得病理完全缓解，34 例（76%）患者降期。中位随访时间为 15 个月（范围为 1-108 个月），所有患者的 3 年生存率为 41%。
通过个体化治疗计划，不同方案的放化疗治疗食管癌可获得可接受的毒性和疗效。
Zotero 插件