Li H-X, Liu J, Cheng Y, Liu M-N, Fang W-T, Lv C-X
Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, P.R. China.
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, P.R. China.
Dis Esophagus. 2018 May 1;31(5). doi: 10.1093/dote/dox144.
A prospective observational study was performed to evaluate the results of treatment with concurrent chemoradiotherapy (CCRT) in patients with cervical esophageal squamous cell carcinoma (CESCC). Patients had CESCC, no distant metastasis, were 18-75 years old, and had PS 0-2. Radiotherapy (RT) was administered as either three-dimensional conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) with a total dose of 60 Gy/30 fractions. All patients were treated with platinum-based doublet concurrent chemotherapeutic regimens. CCRT was followed by 2-3 cycles of consolidation chemotherapy. The endpoints were overall survival (OS), progression-free survival (PFS), toxicities, and failure patterns. Ninety-two patients were enrolled from March 2007 to July 2014. The median follow-up time was 34 months. For all patients, the 3-year OS was 49.8% (median OS: 36 months, 95% CI: 24.963-47.051), and the 3-year PFS was 42.1%, (median PFS: 25 months, 95% CI: 17.097-32.903). Treatment failures occurred in 54 patients, including 30 cases (32.6%) with locoregional failure alone, 14 cases (15.2%) with distant metastasis alone, and 10 cases (10.9%) with both locoregional failure and distant metastasis. There were 51 (55.4%) and 3 cases (3.3%) of grade 3 and grade 5 radiation esophagitis, respectively. One patient (1%) had grade 5 laryngeal edema. Overall, CCRT has tolerable acute toxicities, and this regimen is an option for the treatment of patients with CESCC.
进行了一项前瞻性观察性研究,以评估同步放化疗(CCRT)治疗颈段食管鳞状细胞癌(CESCC)患者的疗效。患者患有CESCC,无远处转移,年龄在18 - 75岁之间,且体能状态(PS)为0 - 2。放疗(RT)采用三维适形放疗(3D - CRT)或调强放疗(IMRT),总剂量为60 Gy/30次分割。所有患者均接受铂类双联同步化疗方案治疗。CCRT后进行2 - 3周期巩固化疗。观察终点为总生存期(OS)、无进展生存期(PFS)、毒性反应和失败模式。2007年3月至2014年7月共纳入92例患者。中位随访时间为34个月。所有患者的3年总生存率为49.8%(中位总生存期:36个月,95%可信区间:24.963 - 47.051),3年无进展生存率为42.1%(中位无进展生存期:25个月,95%可信区间:17.097 - 32.903)。54例患者出现治疗失败,其中仅局部区域失败30例(32.6%),仅远处转移14例(15.2%),局部区域失败合并远处转移10例(10.9%)。分别有51例(55.4%)和3例(3.3%)患者发生3级和5级放射性食管炎。1例患者(1%)发生5级喉水肿。总体而言,CCRT的急性毒性反应可耐受,该方案是CESCC患者治疗的一种选择。