UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2020 Jul;24(14):7589-7597. doi: 10.26355/eurrev_202007_22257.
This review aimed at examining efficacy of interventional radiotherapy (brachytherapy-IRT) alone or combined with external beam radiotherapy (EBRT) in stage I esophageal cancer as exclusive treatment.
A systematic research using PubMed, Scopus, and Cochrane library was performed. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. We analyzed only clinical study as full-text publication, reporting on patients with stage I esophageal cancer treated with IRT alone or in combination with other treatments (e.g., EBRT). Conference paper, survey, letter, editorial, book chapter, and review were excluded. Patients who underwent previous surgery were excluded. Time restriction (1990-2018) was applied for years of the publication.
Twelve studies have been selected. The number of evaluated patients was 514; the median age was 69 years. In the IRT group, the median: local control (LC) was 77% (range 63%-100%), disease-free survival (DFS) was 68.4% (range 49%-86.3%), the overall survival (OS) was 60% (range 31%-84%), the cancer specific survival (CSS) was 80% (range 55-100%), and grade 3-4 toxicity range was 0%-26%.
IRT alone or combined to EBRT is an effective and safe treatment option for patients with stage I esophageal cancer. Definitive radiation therapy could be an alternative to surgery in patients with superficial cancer.
本综述旨在评估单纯腔内近距离放疗（Brachytherapy-IRT）或联合外部束放疗（EBRT）作为根治性治疗在Ⅰ期食管癌中的疗效。
系统检索 PubMed、Scopus 和 Cochrane 图书馆，在 ClinicalTrials.gov 上检索正在进行或最近完成的试验，在 PROSPERO 上检索正在进行或最近完成的系统评价。我们仅分析了以全文形式发表的临床研究，报告了接受单纯 IRT 或联合其他治疗（如 EBRT）治疗的Ⅰ期食管癌患者。排除会议论文、调查、信函、社论、书籍章节和综述。排除既往接受过手术的患者。对出版物年份应用时间限制（1990-2018 年）。
共选择了 12 项研究。评估患者的数量为 514 例，中位年龄为 69 岁。在 IRT 组中，局部控制（LC）的中位数为 77%（范围 63%-100%），无疾病生存率（DFS）为 68.4%（范围 49%-86.3%），总生存率（OS）为 60%（范围 31%-84%），癌症特异性生存率（CSS）为 80%（范围 55%-100%），3-4 级毒性发生率为 0%-26%。
单纯 IRT 或联合 EBRT 是Ⅰ期食管癌患者有效且安全的治疗选择。对于表浅性癌症患者，根治性放疗可以替代手术。
