Zhang Jiaqi, Zhang Wencheng, Zhang Baozhong, Qian Dong, Li Xiaoxia, Zhang Hualei, Wang Qi, Zhao Lujun, Pang Qingsong, Wang Ping
Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, People's Republic of China.
Cancer Manag Res. 2019 Sep 10;11:8285-8294. doi: 10.2147/CMAR.S203575. eCollection 2019.
To evaluate and analyze the efficacy and prognostic factors of intensity-modulated radiotherapy in 250 patients with cervical and upper esophageal carcinoma.
From September 2009 to September 2016, we retrospectively analyzed 250 patients with cervical and upper esophageal carcinoma treated with intensity-modulated radiotherapy (IMRT). In our study, all patients received IMRT, 54 patients with cervical esophageal carcinoma and 196 patients with upper esophageal carcinoma. Treatment response, survival status and failure modes of treatment were observed, and prognostic factors were analyzed.
The median survival time was 22.60 months and 3-year survival rate was 42%. The median progress-free survival time was 14.52 months and 3-year progress-free survival rate was 29.3%. The median survival time and the median progress-free survival time for cervical esophageal carcinoma were 20.40 and 15.15 months, respectively. The median survival time and the median progress-free survival time for upper esophageal carcinoma were 25.80 and 14.52 months, respectively (>0.05). The significant clinical factors associated with survival were patient age, radiotherapy dose and T stages (<0.05). Radiotherapy dose and concurrent chemoradiotherapy were the significant clinical factors related to progression-free survival (<0.05). Recurrence appeared in 55.2% patients, including local recurrence in 22.40%, region relapse in 10.40% and distant metastasis in 12.40%. Local recurrence was the main mode of treatment failure. During treatment, the main treatment-related acute toxicity was leukocytopenia and anemia.
In this study, IMRT demonstrated clinical benefit and well-tolerated toxicity in patients with cervical and upper esophageal carcinoma.
评估和分析250例颈段和上段食管癌患者调强放疗的疗效及预后因素。
回顾性分析2009年9月至2016年9月接受调强放疗（IMRT）的250例颈段和上段食管癌患者。本研究中，所有患者均接受IMRT，其中颈段食管癌患者54例，上段食管癌患者196例。观察治疗反应、生存状况及治疗失败模式，并分析预后因素。
中位生存时间为22.60个月，3年生存率为42%。中位无进展生存时间为14.52个月，3年无进展生存率为29.3%。颈段食管癌的中位生存时间和中位无进展生存时间分别为20.40个月和15.15个月。上段食管癌的中位生存时间和中位无进展生存时间分别为25.80个月和14.52个月（>0.05）。与生存相关的显著临床因素为患者年龄、放疗剂量和T分期（<0.05）。放疗剂量和同步放化疗是与无进展生存相关的显著临床因素（<0.05）。55.2%的患者出现复发，其中局部复发占22.40%，区域复发占10.40%，远处转移占12.40%。局部复发是主要的治疗失败模式。治疗期间，主要的治疗相关急性毒性为白细胞减少和贫血。
本研究中，调强放疗在颈段和上段食管癌患者中显示出临床获益且毒性耐受性良好。
