Anvari Kazem, Aledavood Seyed Amir, Toussi Mehdi Seilanian, Forghani Mohammad Naser, Mohtashami Samira, Rajabi Mohammad Taghi, Shandiz Fatemeh Homaee, Nosrati Fatemeh, Nowferesti Gholamhossein, Salek Roham
Cancer Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
J Res Med Sci. 2015 Aug;20(8):751-6. doi: 10.4103/1735-1995.168377.
Esophageal carcinoma is a common malignancy in the North East of Iran. Combined modality treatments have been adopted to improve survival in patients with esophageal carcinoma. In this trial, we evaluated the efficacy and toxicity of a preoperative concurrent chemoradiotherapy protocol in the patients with locally advanced esophageal carcinoma.
Between 2006 and 2011, eligible patients with locally advanced esophageal carcinoma underwent concurrent radiotherapy and chemotherapy and 3-4 weeks later, esophagectomy. Pathologic response, overall survival rate, toxicity, and feasibility were evaluated.
One hundred ninety-seven patients with a median age of 59 (range: 27-70) entered the protocol. One hundred ninety-four cases (98.5%) had esophageal squamous cell carcinoma. Grades 3-4 of toxicity in patients undergoing neoadjuvant chemoradotherapy were as follows: Neutropenia in 21% and esophagitis in 2.5% of cases. There were 11 (5.6%) early death probably due to the treatment-related toxicities. One hundred twenty-seven patients underwent surgery with postsurgical mortality of 11%. In these cases, the complete pathological response was shown in 38 cases (29.9%) with a 5-year overall survival rates of 48.2% and median overall survival of 44 months (95% confidence interval, 24.46-63.54).
The pathological response rate and the overall survival rate are promising in patients who completed the protocol as receiving at least one cycle of chemotherapy. However, the treatment toxicities were relatively high.
食管癌是伊朗东北部一种常见的恶性肿瘤。已采用综合治疗方法来提高食管癌患者的生存率。在本试验中，我们评估了术前同步放化疗方案对局部晚期食管癌患者的疗效和毒性。
2006年至2011年期间，符合条件的局部晚期食管癌患者接受同步放疗和化疗，3 - 4周后进行食管切除术。评估病理反应、总生存率、毒性和可行性。
197例患者进入该方案，中位年龄为59岁（范围：27 - 70岁）。194例（98.5%）为食管鳞状细胞癌。接受新辅助放化疗患者的3 - 4级毒性如下：21%的患者出现中性粒细胞减少，2.5%的患者出现食管炎。有11例（5.6%）早期死亡，可能与治疗相关毒性有关。127例患者接受了手术，术后死亡率为11%。在这些病例中，38例（29.9%）显示完全病理缓解，5年总生存率为48.2%，中位总生存期为44个月（95%置信区间，24.46 - 63.54）。
对于完成方案且至少接受一个周期化疗的患者，病理缓解率和总生存率前景良好。然而，治疗毒性相对较高。
