根治性同期放化疗中辅助化疗与剂量递增治疗食管鳞癌。
Adjuvant Chemotherapy and Dose Escalation in Definitive Concurrent Chemoradiotherapy for Esophageal Squamous Cell Carcinoma.
机构信息
Department of Radiation Oncology, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Republic of Korea.
Department of Radiation Oncology/CyberKnife Center, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
出版信息
Anticancer Res. 2020 Mar;40(3):1771-1778. doi: 10.21873/anticanres.14131.
BACKGROUND/AIM: To validate the effect of treatment intensification on survival in esophageal squamous cell carcinoma (ESCC) patients undergoing definitive concurrent chemoradiotherapy (dCCRT).
PATIENTS AND METHODS
We reviewed the medical records of 73 ESCC patients who underwent dCCRT between 2006 and 2017 in 3 institutions.
RESULTS
The median follow-up time was 13.3 months. The median overall survival (OS) and locoregional recurrence-free survival (LRFS) were 13.3 and 11.2 months, respectively. The median radiotherapy dose was 55.8 Gy, and the median biologically effective dose (BED) was 65.8 Gy. Chemotherapy was given in all patients during dCCRT, and adjuvant chemotherapy was administered in 56 patients (76.7%). Adjuvant chemotherapy improved OS (3-year, 24.2% vs. 11.8%, p=0.004). Higher BED ≥70 Gy improved LRFS (3-year, 41.7% vs. 23.6%, p=0.035).
CONCLUSION
The addition of chemotherapy after dCCRT improves OS. A higher radiotherapy dose improved LRFS, but not OS. Adjuvant chemotherapy should be considered after dCCRT for better outcomes.
背景/目的：验证强化治疗对接受根治性同期放化疗（dCCRT）的食管鳞癌（ESCC）患者生存的影响。
患者与方法
我们回顾了 3 家机构在 2006 年至 2017 年间接受 dCCRT 的 73 例 ESCC 患者的病历。
结果
中位随访时间为 13.3 个月。中位总生存期（OS）和局部区域无复发生存期（LRFS）分别为 13.3 个月和 11.2 个月。中位放疗剂量为 55.8 Gy，中位生物有效剂量（BED）为 65.8 Gy。所有患者在 dCCRT 期间均接受化疗，56 例（76.7%）患者接受辅助化疗。辅助化疗改善了 OS（3 年，24.2% vs. 11.8%，p=0.004）。较高的 BED≥70 Gy 改善了 LRFS（3 年，41.7% vs. 23.6%，p=0.035）。
结论
dCCRT 后添加化疗可提高 OS。较高的放疗剂量改善了 LRFS，但对 OS 没有影响。dCCRT 后应考虑辅助化疗以获得更好的疗效。
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