Department of Thoracic Oncology and Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, PR China.
Radiat Oncol. 2012 Jun 19;7:93. doi: 10.1186/1748-717X-7-93.
To evaluate the treatment outcome of salvage concurrent radio-chemotherapy for patients with loco-recurrent esophageal cancer after surgery.
50 patients with loco-recurrent squamous-cell cancer after curative esophagectomy were retrospectively analyzed. Patients were treated with radiotherapy (median 60 Gy) combined with chemotherapy consisting of either 5-fluorouracil (5-FU) plus cisplatin (DDP) (R-FP group) or paclitaxel plus DDP (R-TP group).
The median follow-up period was 16.0 months. The 1-year and 3-year survival rates were 56% and 14%, respectively. The median progression-free survival (PFS) and overall survival (OS) time was 9.8 and 13.3 months respectively. There was no statistical significance of the PFS of the two groups. The OS (median 16.3 months) in the R-TP group was superior to that in the R-FP group (median: 9.8 months) (p = 0.012). Among the patients who had received ≥60 Gy irradiation dose, the median PFS (10.6 months) and OS (16.3 months) were significantly superior to the PFS (8.7 months) and OS (11.3 months) among those patients did not (all p < 0.05). Grade 3 treatment-related gastritis were observed in 6 (27.3%) and 7 (25%) patients in the R-FP and R-TP group respectively. By univariate survival analysis, the age (<60 years), TP regimen and higher irradiation dose might improve the OS of such patients in present study.
For those patients with post-operative loco-recurrent squamous-cell esophageal carcinoma, radiotherapy combined with either FP or TP regimen chemotherapy was an effective salvage treatment. Younger age, treatment with the TP regimen and an irradiation dose ≥60 Gy might improve the patients' treatment outcome.
评估手术治疗后局部复发性食管癌患者挽救性同期放化疗的治疗效果。
回顾性分析 50 例根治性食管癌术后局部复发性鳞癌患者，给予放疗（中位剂量 60Gy）联合化疗，化疗方案分别为氟尿嘧啶+顺铂（R-FP 组）或紫杉醇+顺铂（R-TP 组）。
中位随访时间为 16.0 个月。1 年和 3 年生存率分别为 56%和 14%。中位无进展生存期（PFS）和总生存期（OS）分别为 9.8 和 13.3 个月。两组患者的 PFS 无统计学差异。R-TP 组的 OS（中位 16.3 个月）优于 R-FP 组（中位 9.8 个月）（p=0.012）。在接受≥60Gy 照射剂量的患者中，中位 PFS（10.6 个月）和 OS（16.3 个月）明显优于未接受≥60Gy 照射剂量的患者（PFS 8.7 个月，OS 11.3 个月）（均 p<0.05）。R-FP 组和 R-TP 组各有 6 例（27.3%）和 7 例（25%）患者发生 3 级治疗相关胃炎。单因素生存分析显示，年龄（<60 岁）、TP 方案和较高的照射剂量可能改善本研究患者的 OS。
对于术后局部复发性食管鳞癌患者，放疗联合 FP 或 TP 方案化疗是一种有效的挽救性治疗方法。年龄较轻、TP 方案治疗和照射剂量≥60Gy 可能改善患者的治疗效果。
