Zhang Wei, Luo Yijun, Wang Xiaoli, Han Gaohua, Wang Peng, Yuan Wei, Dai Sheng-Bin
Department of Oncology, Taizhou People's Hospital, Taizhou, Jiangsu, People's Republic of China,
Department of Oncology, The People's Hospital of Jiangxi Province, Nanchang, Jiangxi, People's Republic of China.
Cancer Manag Res. 2018 Aug 14;10:2675-2682. doi: 10.2147/CMAR.S160909. eCollection 2018.
For esophageal cancer patients with a clinical complete response (cCR) after standard-dose radiotherapy with concurrent chemotherapy, data on the survival outcomes and recurrence patterns remain scarce. To evaluate the impact of dose escalation on overall survival for this subset of patients, we carried out the current investigation.
Medical records of 80 esophageal cancer patients with a cCR after standard-dose radiotherapy with concurrent chemotherapy at our center from 2010 to 2014 were allocated into the standard-dose group (50.4 Gy, observation group) or the radiation dose-escalation group (59.4 Gy, control group). In this cohort study, we compared the outcomes between the 2 groups.
There were no differences in patient characteristics between the 2 groups. The median recurrence-free survival and overall survival times for all patients were 38 and 54 months, respectively. Patients in the control group had significantly better 5-year recurrence-free survival rate (12% vs 0%, =0.019) and 5-year overall survival rate (42.8% vs 21.0%, =0.028) than the observation group. Additionally, local control rate was significantly higher in the control group (=0.04), and ~60% of treatment failures were local failures even for patients achieving cCR after chemoradiotherapy. There were no significant differences in treatment-related toxicities between the groups.
The results of the current study suggest that for esophageal cancer patients with a cCR after standard-dose radiotherapy with concurrent chemotherapy, those with dose-escalated radiotherapy showed significantly better local control, recurrence-free survival, and overall survival than patients receiving 50.4 Gy radiotherapy.
对于接受标准剂量放疗联合化疗后达到临床完全缓解（cCR）的食管癌患者，关于生存结局和复发模式的数据仍然匮乏。为了评估剂量递增对这部分患者总生存的影响，我们开展了本研究。
将2010年至2014年在本中心接受标准剂量放疗联合化疗后达到cCR的80例食管癌患者的病历分为标准剂量组（50.4 Gy，观察组）或放疗剂量递增组（59.4 Gy，对照组）。在这项队列研究中，我们比较了两组的结局。
两组患者的特征无差异。所有患者的无复发生存期和总生存期的中位数分别为38个月和54个月。对照组患者的5年无复发生存率（12%对0%，P=0.019）和5年总生存率（42.8%对21.0%，P=0.028）均显著优于观察组。此外，对照组的局部控制率显著更高（P=0.04），即使是在放化疗后达到cCR的患者中，约60%的治疗失败为局部失败。两组之间的治疗相关毒性无显著差异。
本研究结果表明，对于接受标准剂量放疗联合化疗后达到cCR的食管癌患者，接受剂量递增放疗的患者在局部控制、无复发生存和总生存方面均显著优于接受50.4 Gy放疗的患者。
