Murakami Yuji, Takahashi Ippei, Nishibuchi Ikuno, Doi Yoshiko, Okabe Tomoyuki, Kenjo Masahiro, Kimura Tomoki, Nagata Yasushi
Department of Radiation Oncology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Radiation Oncology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan.
Int J Clin Oncol. 2015 Oct;20(5):897-904. doi: 10.1007/s10147-015-0819-2. Epub 2015 Mar 24.
The long-term outcomes of definitive concurrent chemoradiotherapy for patients with esophageal submucosal cancer without regional and distant metastasis were retrospectively analyzed.
Patients with histologically confirmed esophageal submucosal cancers without regional and distant metastasis who received definitive concurrent chemoradiotherapy from 2001 to 2011 were included. Radiation therapy of a median total dose of 60 Gy/30 fractions (range, 54-66 Gy) with elective nodal irradiation of 40 Gy was combined concurrently with 5-furuorouracil-based chemotherapy.
Thirty-six patients (33 men and 3 women) aged from 45 to 80 years (median, 67 years) were assessed. All patients had squamous cell carcinoma. With a median follow-up time of 61 months, the 5-year overall survival, disease-free survival, and locoregional failure-free survival rates were 86 % [95 % confidence interval (CI), 74-99 %], 59 % (95 % CI, 42-77 %), and 90 % (95 % CI, 79-100 %), respectively. Late toxicities of grade 3 pleural effusion in 2 patients, grade 4 pericardial effusion in 1 patient, and grade 5 pneumonitis in 1 patient were observed. Metachronous esophageal cancer was observed in 8 patients (22 %). Among them, 6 patients with mucosal legions were salvaged by endoscopic resection.
Our long-term results of concurrent chemoradiotherapy (CCRT) for patients with esophageal submucosal cancer showed acceptable toxicities and favorable locoregional control and survivals while maintaining organ preservation.
回顾性分析了接受确定性同步放化疗的无区域和远处转移的食管黏膜下癌患者的长期预后。
纳入2001年至2011年期间接受确定性同步放化疗、组织学确诊为无区域和远处转移的食管黏膜下癌患者。中位总剂量为60 Gy/30次分割（范围54 - 66 Gy）的放射治疗联合40 Gy的选择性淋巴结照射，同时与基于5-氟尿嘧啶的化疗联合应用。
评估了36例患者（33例男性和3例女性），年龄45至80岁（中位年龄67岁）。所有患者均为鳞状细胞癌。中位随访时间为61个月，5年总生存率、无病生存率和局部区域无复发生存率分别为86%[95%置信区间（CI），74 - 99%]、59%（95%CI，42 - 77%）和90%（95%CI，79 - 100%）。观察到2例3级胸腔积液、1例4级心包积液和1例5级肺炎的晚期毒性反应。8例患者（22%）发生异时性食管癌。其中，6例黏膜病变患者通过内镜切除得以挽救。
我们对食管黏膜下癌患者进行同步放化疗（CCRT）的长期结果显示，毒性反应可接受，局部区域控制良好，生存率较高，同时保持了器官功能。
