局部野放疗而非选择性淋巴结照射用于食管癌术后局部区域复发

Local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer.

作者信息

Kimoto Takuya, Yamazaki Hideya, Suzuki Gen, Aibe Norihiro, Masui Koji, Tatekawa Kotoha, Sasaki Naomi, Fujiwara Hitoshi, Shiozaki Atsushi, Konishi Hirotaka, Nakamura Satoaki, Yamada Kei

机构信息

Department of Radiology, Kyoto Prefectural University of Medicine.

Department of Digestive Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto.

出版信息

Jpn J Clin Oncol. 2017 Sep 1;47(9):809-814. doi: 10.1093/jjco/hyx092.

DOI:10.1093/jjco/hyx092

PMID:28903531

Abstract

BACKGROUND

Radiotherapy is an effective treatment for the postoperative loco-regional recurrence of esophageal cancer; however, the optimal treatment field remains controversial. This study aims to evaluate the outcome of local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer.

METHODS

We retrospectively investigated 35 patients treated for a postoperative loco-regional recurrence of esophageal cancer with local field radiotherapy between December 2008 and March 2016. The median irradiation dose was 60 Gy (range: 50-67.5 Gy). Thirty-one (88.6%) patients received concurrent chemotherapy.

RESULTS

The median follow-up period was 18 months (range: 5-94 months). The 2-year overall survival was 55.7%, with a median survival time of 29.9 months. In the univariate analysis, the maximal diameter ≤20 mm (P = 0.0383), solitary lesion (P = 0.0352), and the complete remission after treatment (P = 0.00411) had a significantly better prognosis. A total of 27 of 35 patients (77.1%) had progressive disease (loco-regional failure [n = 9], distant metastasis [n = 7], and both loco-regional failure and distant metastasis [n = 11]). No patients had Grade 3 or greater mucositis.

CONCLUSION

Local field radiotherapy is a considerable treatment option for postoperative loco-regional recurrence of esophageal cancer.

摘要

背景

放射治疗是食管癌术后局部区域复发的有效治疗方法；然而，最佳治疗野仍存在争议。本研究旨在评估食管癌术后局部区域复发采用局部野放射治疗且不进行选择性淋巴结照射的疗效。

方法

我们回顾性研究了2008年12月至2016年3月期间接受局部野放射治疗的35例食管癌术后局部区域复发患者。中位照射剂量为60 Gy（范围：50 - 67.5 Gy）。31例（88.6%）患者接受了同步化疗。

结果

中位随访期为18个月（范围：5 - 94个月）。2年总生存率为55.7%，中位生存时间为29.9个月。单因素分析显示，最大直径≤20 mm（P = 0.0383）、孤立性病变（P = 0.0352）以及治疗后完全缓解（P = 0.00411）的患者预后明显更好。35例患者中有27例（77.1%）出现疾病进展（局部区域失败[n = 9]、远处转移[n = 7]以及局部区域失败和远处转移均有[n = 11]）。无患者发生3级或更高级别的黏膜炎。