Department of Oncology, the Affiliated Zhangjiagang Hospital of Soochow University, Suzhou, China.
Department of Oncology, The Second Hospital of Nanjing Jiangning, Nanjing, China.
Oncol Res Treat. 2019;42(9):470-479. doi: 10.1159/000501594. Epub 2019 Jul 25.
Definitive radiotherapy has an affirmative role in treating non-operable esophageal cancer; however, the controversy between elective lymph node irradiation (ENI) and involved-field irradiation (IFI) still remains. To ascertain the benefits and disadvantages of the two radiation target volumes, we performed a meta-analysis with 7 related publications. According to our findings, patients treated with ENI and IFI had nearly identical 1, 2, and 3-year survival rates (pooled odds ratio [OR] = 1.004, p = 0.980, and pooled OR = 1.15, p = 0.594, and pooled OR = 0.918, p = 0.679, respectively). Likewise, no significant differences were detected in local recurrence rates (pooled OR = 1.04, p = 0.883), regional recurrence rates (pooled OR = 0.65, p = 0.555), and distant metastasis rates (pooled OR = 1.29, p = 0.309) between the two treatment groups. However, IFI could significantly decrease the incidences of acute radiation esophagitis (pooled OR = 2.30, p = 0.001) and late pneumonia (pooled OR = 2.52, p = 0.04) compared with ENI. This meta-analysis provides evidence that IFI is more feasible for non-operable esophageal cancer than ENI.
根治性放疗在治疗不可手术的食管癌中具有肯定的作用；然而，选择性淋巴结照射（ENI）和累及野照射（IFI）之间的争议仍然存在。为了确定这两种放射靶区的优缺点，我们对 7 篇相关文献进行了荟萃分析。根据我们的发现，接受 ENI 和 IFI 治疗的患者的 1、2 和 3 年生存率几乎相同（汇总优势比 [OR] = 1.004，p = 0.980，和汇总 OR = 1.15，p = 0.594，和汇总 OR = 0.918，p = 0.679）。同样，两组之间局部复发率（汇总 OR = 1.04，p = 0.883）、区域复发率（汇总 OR = 0.65，p = 0.555）和远处转移率（汇总 OR = 1.29，p = 0.309）无显著差异。然而，IFI 与 ENI 相比，可显著降低急性放射性食管炎（汇总 OR = 2.30，p = 0.001）和晚期肺炎（汇总 OR = 2.52，p = 0.04）的发生率。这项荟萃分析提供了证据，表明 IFI 比 ENI 更适用于不可手术的食管癌。
