根治性放化疗后局部复发性食管癌患者的挽救性放疗
Salvage radiotherapy in patients with local recurrent esophageal cancer after radical radiochemotherapy.
作者信息
Zhou Zhi-guo, Zhen Chan-jun, Bai Wen-wen, Zhang Ping, Qiao Xue-ying, Liang Jun-li, Gao Xian-shu, Wang Shuo-shuo
机构信息
Department of Radiation Oncology, Peking University First Hospital, Beijing, 100034, China.
Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050011, China.
出版信息
Radiat Oncol. 2015 Feb 27;10:54. doi: 10.1186/s13014-015-0358-z.
PURPOSE
The aim of this study was to evaluate the salvage radiotherapy outcome in patients with local recurrent esophageal cancer after radical radiochemotherapy (RCT).
METHODS
A total of 114 patients with local recurrent esophageal squamous cell carcinoma after initial radical RCT were retrospectively analyzed. Fifty-five (55) patients belonged to the salvage radiotherapy group (SR group) and 59 patients to the non-salvage radiotherapy group (NSR group).
RESULTS
The median survival time after-recurrence was 4 months in all patients. The 1, 2, 3 year overall survival (OS) rates were 83.6%, 41.8% and 21.8% respectively in the SR group, and 57.6%, 16.9%, and 8.5% in the NSR group. The 6-month and 1-year survival rates after-recurrence were 41.8% and 16.4% respectively in the SR group, and 11.9% and 3.4% respectively in the NSR group. A salvage radiation dose > 50 Gy after initial radical RCT, improved the survival of patients with local recurrent esophageal cancer. Three patients (5.45%) from the SR group showed more than 3-grade radiation pneumonitis. In addition, esophageal fistula/perforation was observed in 11 cases (20.0%) in the SR group and in 8 cases (13.6%) in the NSR group.
CONCLUSIONS
Salvage treatment after definitive RCT may improve the overall survival and survival after-recurrence of patients with local recurrent esophageal cancer.
目的
本研究旨在评估根治性放化疗（RCT）后局部复发食管癌患者的挽救性放疗效果。
方法
回顾性分析114例初始根治性RCT后局部复发食管鳞状细胞癌患者。55例患者属于挽救性放疗组（SR组），59例患者属于非挽救性放疗组（NSR组）。
结果
所有患者复发后的中位生存时间为4个月。SR组1年、2年、3年总生存率（OS）分别为83.6%、41.8%和21.8%，NSR组分别为57.6%、16.9%和8.5%。SR组复发后6个月和1年生存率分别为41.8%和16.4%，NSR组分别为11.9%和3.4%。初始根治性RCT后挽救性放疗剂量>50 Gy可提高局部复发食管癌患者的生存率。SR组3例患者（5.45%）出现3级以上放射性肺炎。此外，SR组11例患者（20.0%）和NSR组8例患者（13.6%）观察到食管瘘/穿孔。
结论
根治性RCT后的挽救性治疗可能提高局部复发食管癌患者的总生存率和复发后的生存率。
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