Ma Kai, Wang Qifeng, Li Tao, Liu Huiming, Liu Bo, Jia Xitang, Li Shufeng, Lang Junyuan, Zhang Mingzhi
Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
General Hospital of Jincheng Anthracite Mining Group Co.Ltd, Jincheng, China.
Radiat Oncol. 2014 Dec 17;9:294. doi: 10.1186/s13014-014-0294-3.
The aim of this study was to retrospectively observe and analyze the long-term treatment outcomes of a total of 140 esophageal cancer patients who were treated with californium-252 ((252)Cf) neutron brachytherapy (NBT) in combination with external beam radiotherapy (EBRT) and concurrent chemotherapy (CCT).
From January 2002 to November 2012, 140 patients with esophageal cancer underwent NBT in combination with EBRT and CCT. The distribution of the patient numbers over the various cancer stages of IIA, IIB, and III were 43, 7, and 90, respectively. The total radiation dose to the reference point via NBT was 8-25 Gy-eq in two to five fractions with one fraction per week. The total dose via EBRT was 50-60 Gy, which was delivered over a period of five to six weeks with normal fractionation. Fifty-four and 86 patients received tegafur suppositories (TS) and continuous infusion of fluorouracil (5-Fu) with cisplatin (CDDP), respectively.
The median follow-up time was 42 months. The minimum follow-up was three months, and the maximum was 106 months. The overall median survival including death from all causes was 29.5 months. The five-year overall survival rate (OS) and local control (LC) were 33.4% and 55.9%, respectively. The chemotherapy regimen was a factor that was significantly associated with OS (p = 0.025) according to univariate analysis. The five-year OSs were 27.4% and 44.3% for the PF and TS chemotherapy regimens, respectively. Regarding acute toxicity, no incidences of fistula or massive bleeding were observed during this treatment period. The incidence of severe, late complications was related to the PF chemotherapy regimen (p = 0.080).
The clinical data indicated that NBT in combination with EBRT and CRT produced favorable local control and long-term survival rates for patients with esophageal cancer and that the side effects were tolerable. A reasonable CRT regimen can decrease the rate of severe, late complications.
本研究旨在回顾性观察和分析140例接受锎-252（²⁵²Cf）中子近距离放射治疗（NBT）联合外照射放疗（EBRT）及同步化疗（CCT）的食管癌患者的长期治疗效果。
2002年1月至2012年11月，140例食管癌患者接受了NBT联合EBRT及CCT治疗。IIA、IIB和III期各癌症阶段的患者人数分布分别为43例、7例和90例。通过NBT给予参考点的总辐射剂量为8 - 25 Gy - eq，分两至五次给予，每周一次。通过EBRT的总剂量为50 - 60 Gy，以常规分割方式在五至六周内给予。54例和86例患者分别接受替加氟栓剂（TS）以及氟尿嘧啶（5 - Fu）持续输注联合顺铂（CDDP）治疗。
中位随访时间为42个月。最短随访时间为3个月，最长为106个月。包括各种原因导致的死亡在内的总体中位生存期为29.5个月。五年总生存率（OS）和局部控制率（LC）分别为33.4%和
