Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC 29425, USA.
Jpn J Clin Oncol. 2011 Mar;41(3):334-42. doi: 10.1093/jjco/hyq208. Epub 2010 Nov 17.
Cisplatin-based chemoradiotherapy is standard treatment for locally advanced esophageal and gastroesophageal cancers; however, the optimal chemotherapy regimen remains to be defined.
Retrospective single institution analysis of toxicities, response rates and survival outcomes in patients with cT3-4 or N1/M1a esophageal squamous cell or adenocarcinoma treated with induction cisplatin and irinotecan followed by concurrent cisplatin, irinotecan and radiotherapy. Secondary analysis for association of disease control and outcomes with demographic, tumor and treatment factors (including histology).
Fifty-three patients were eligible for the present analysis. All patients underwent endoscopic ultrasonography and were either cT3-4 and/or cN1 disease. Fifty patients completed radiotherapy as planned (median dose 50.4 Gy, range 0-61.2), and 35 patients completed four cycles of chemotherapy as planned (range 1-4). Severe acute toxicities included Grade ≥ 3 neutropenia and esophagitis in 13 and 12 patients, respectively. There were no Grade 5 (fatal) toxicities noted. At mean survivor follow-up of 24.5 months (range 2.7-63), 17 patients were alive (8 without disease) and 36 deceased. Forty patients experienced disease recurrence, with initial loco-regional, distant or both failures in 28, 9 and 3 patients, respectively. Estimated 2-year overall survival and freedom from failure were 42 and 9%, respectively, without significant difference by histology.
Cisplatin/irinotecan chemoradiotherapy is tolerable, demonstrating similar efficacy for squamous cell and adenocarcinoma esophageal cancers.
顺铂为基础的放化疗是局部晚期食管和胃食管交界处癌的标准治疗方法；然而，最佳化疗方案仍有待确定。
回顾性分析单机构接受诱导顺铂和伊立替康联合同期顺铂、伊立替康和放疗的 T3-4 或 N1/M1a 食管鳞癌或腺癌患者的毒性、反应率和生存结果。次要分析疾病控制和结局与人口统计学、肿瘤和治疗因素（包括组织学）的相关性。
53 例患者符合本分析条件。所有患者均接受内镜超声检查，且均为 cT3-4 和/或 cN1 疾病。50 例患者按计划完成放疗（中位剂量 50.4Gy，范围 0-61.2），35 例患者按计划完成 4 个周期化疗（范围 1-4）。严重急性毒性包括 13 例≥3 级中性粒细胞减少症和 12 例食管炎。无 5 级（致命）毒性。在平均随访 24.5 个月（范围 2.7-63）后，17 例患者存活（8 例无疾病），36 例死亡。40 例患者发生疾病复发，分别有 28 例、9 例和 3 例患者最初出现局部区域、远处或两者的失败。估计 2 年总生存率和无失败生存率分别为 42%和 9%，组织学无显著差异。
顺铂/伊立替康放化疗可耐受，对食管鳞癌和腺癌疗效相似。
