中国食管癌放射治疗的文献分析

Literature analysis of radiotherapy for esophageal cancer in China.

作者信息

Zhou Zhi-Guo, Gao Xian-Shu, Qiao Xue-Ying, Zhang Ping

机构信息

Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, PR China.

出版信息

Chin J Cancer. 2010 Oct;29(10):873-81. doi: 10.5732/cjc.010.10165.

DOI:10.5732/cjc.010.10165

PMID:20868557

Abstract

BACKGROUND AND OBJECTIVE

Many patterns of treatment have been used to treat esophageal carcinoma in the past years, however, an optimal treatment is still the key issue to be explored. Therefore, we analyzed the published literature about radiotherapy for esophageal cancer in recent 15 years in China, and observed the survival rate, local control rate, adverse events, and so on.

METHODS

A total of 56 eligible papers about radiotherapy for esophageal squamous cell carcinoma published in Chinese core periodicals between 1994 and 2009 were selected. The survival rates, local control rates, and adverse events were analyzed.

RESULTS

The 1-, 2-, 3-, and 5-year overall survival rates of the patients reported in the 56 papers were (67.99 ± 12.55)%, (49.59 ± 11.79)%, (34.50 ± 11.49)%, and (23.31 ± 10.21)%, respectively. The 1-, 2-, 3-, and 5-year local control rates were (73.04 ± 13.37)%, (61.60 ± 15.50)%, (51.77 ± 15.00)%, and (50.15 ± 21.36)%, respectively. The acute esophageal toxicity rate was (44.84 ± 25.71)% in 32 papers reported in recent 15 years, and the acute esophageal toxicity over grade II accounted for (35.93 ± 22.90)%. The rates of acute esophageal toxicity were (26.84 ± 13.12)% for conventional radiation, (53.72 ± 21.82)% for late course accelerated hyperfractionation radiation, (61.33 ± 28.69)% for concurrent chemoradiotherapy, and (40.31 ± 27.22)% for other ways of radiation. The late toxicity rate described in 23 papers was (5.13 ± 4.07)% in recent 15 years. The late toxicity rates were (5.66 ± 3.42)% for conventional radiation, (4.53± 4.07)% for late course accelerated hyperfractionation radiation, (2.24±1.31)% for concurrent chemoradiotherapy, and (7.34 ± 5.06)% for other ways of radiation. The Meta analysis indicated that concurrent chemoradiotherapy was better than late course accelerated hyperfractionation radiation and conventional radiation.

CONCLUSIONS

The long-term survival of patients with esophageal cancer is still disappointed in recent years. Concurrent chemoradiotherapy shows advantages in treating esophageal cancer and, currently, is the best non-surgical treatment of esophageal cancer.

摘要

背景与目的

过去数年中已采用多种治疗模式来治疗食管癌，然而，最佳治疗方案仍是有待探索的关键问题。因此，我们分析了中国近15年发表的有关食管癌放疗的文献，并观察生存率、局部控制率、不良事件等情况。

方法

选取1994年至2009年期间在中国核心期刊上发表的56篇关于食管鳞状细胞癌放疗的合格论文。对生存率、局部控制率及不良事件进行分析。

结果

56篇论文报道的患者1年、2年、3年和5年总生存率分别为(67.99±12.55)%、(49.59±11.79)%、(34.50±11.49)%和(23.31±10.21)%。1年、2年、3年和5年局部控制率分别为(73.04±13.37)%、(61.60±15.50)%、(51.77±15.00)%和(50.15±21.36)%。近15年32篇论文报道的急性食管毒性发生率为(44.84±25.71)%，Ⅱ级以上急性食管毒性占(35.93±22.90)%。常规放疗的急性食管毒性发生率为(26.84±13.12)%，后程加速超分割放疗为(53.72±21.82)%，同步放化疗为(61.33±28.69)%，其他放疗方式为(40.31±27.22)%。23篇论文描述的近15年晚期毒性发生率为(5.13±4.07)%。常规放疗的晚期毒性发生率为(5.66±3.42)%，后程加速超分割放疗为(4.53±4.07)%，同步放化疗为(2.24±1.31)%，其他放疗方式为(7.34±5.06)%。Meta分析表明，同步放化疗优于后程加速超分割放疗和常规放疗。