Hamer Peter W, Hight Stephanie C, Ward Ian G, Harris Dean L, Woodham Benjamin L, Flint Richard S
Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
Canterbury Regional Cancer and Haematology Service, Christchurch Hospital, Christchurch, New Zealand.
ANZ J Surg. 2019 Apr;89(4):367-371. doi: 10.1111/ans.14981. Epub 2019 Feb 21.
Definitive chemoradiation for oesophageal squamous cell carcinoma (SCC) is the first-line treatment in many centres. However, it is not without morbidity. We assess outcomes for patients treated with definitive chemoradiotherapy and radiotherapy.
A retrospective review of a prospectively maintained database (Radiotherapy Department, Canterbury District Health Board) was undertaken. All patients who underwent definitive radiotherapy for oesophageal SCC between October 1996 and April 2015 were included.
Sixty patients underwent chemoradiotherapy with curative intent and 17 underwent definitive radiotherapy with curative intent. Median age was 69 years (44-84 years) for those undergoing chemoradiotherapy and 73 years (36-85 years) for those who underwent definitive radiotherapy. Tumour location in all patients was upper third in 14 (18%), middle third in 39 (51%), lower third in 22 (29%) cases and junctional tumour in two (3%). Staging information was complete for 73 of 77 patients (stage I 16/77 (21%), stage II 40/77 (52%), stage III 17/77 (22%)). Median dose of external beam radiotherapy for those who underwent definitive chemotherapy was 50.4 Gy (30-63 Gy) and 60 Gy (50-64 Gy) for definitive radiotherapy. Median length of follow-up was 39 months (range 4-120 months). Strictures developed in 58% of all patients (52% chemoradiotherapy and 76% definitive radiotherapy). Twenty-four (32%) patients were dilated and 14 (18%) stented. The chemoradiotherapy group had higher 5-year survival than definitive radiotherapy group (34% versus 6%, P = 0.0034).
Oesophageal SCC treated with chemoradiation has a 5-year survival rate of 34%. Post-treatment strictures occur in 52% of patients with chemoradiotherapy and 76% with definitive radiotherapy.
在许多中心，食管癌鳞状细胞癌（SCC）的根治性放化疗是一线治疗方法。然而，它并非没有并发症。我们评估接受根治性放化疗和放疗患者的治疗结果。
对一个前瞻性维护的数据库（坎特伯雷地区卫生局放疗科）进行回顾性分析。纳入1996年10月至2015年4月期间所有接受食管癌鳞状细胞癌根治性放疗的患者。
60例患者接受了根治性放化疗，17例接受了根治性放疗。接受放化疗患者的中位年龄为69岁（44 - 84岁），接受根治性放疗患者的中位年龄为73岁（36 - 85岁）。所有患者中，肿瘤位于食管上段的有14例（18%），中段39例（51%），下段22例（29%），食管交界性肿瘤2例（3%）。77例患者中有73例分期信息完整（I期16/77（21%），II期40/77（52%），III期17/77（22%））。接受根治性化疗患者的外照射放疗中位剂量为50.4 Gy（30 - 63 Gy），根治性放疗患者为60 Gy（50 - 64 Gy）。中位随访时间为39个月（范围4 - 120个月）。所有患者中有58%出现狭窄（放化疗患者为52%，根治性放疗患者为76%）。24例（32%）患者接受了扩张治疗，14例（18%）患者置入了支架。放化疗组的5年生存率高于根治性放疗组（3
