Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2 Onohigashi, Osakasayama, Osaka, Japan.
Esophagus. 2021 Jul;18(3):638-644. doi: 10.1007/s10388-020-00812-y. Epub 2021 Jan 8.
The role of intensity-modulated radiation therapy in the treatment of cervical esophageal cancer remains unclear. The outcome of concurrent chemoradiotherapy for cervical esophageal squamous cell carcinoma using intensity-modulated radiation therapy was retrospectively evaluated.
Between 2004 and 2017, 36 patients with cervical esophageal cancer treated with intensity-modulated radiation therapy were included. Among these patients, one had stage II disease, three stage III, 19 stage IVA, and 13 stage IVB. All patients received radiotherapy at a dose of 60 Gy and concurrent platinum-based doublet chemotherapy.
The median follow-up period for surviving patients was 36 months. Three-year locoregional control, progression-free survival, and overall survival rates were 54, 40, and 46%, respectively. Disease progression was noted in 20 out of 36 patients (56%). Grade 3 late toxicities were observed in four patients (three esophageal stenoses and one carotid artery stenosis). There were no grade 4-5 toxicities. Univariate analysis identified the duration of radiotherapy as a prognostic factor for overall survival.
Chemoradiotherapy using intensity-modulated radiation therapy for locally advanced cervical esophageal carcinoma achieved satisfactory locoregional control and survival with acceptable toxicities.
调强放疗在治疗颈段食管癌中的作用尚不清楚。本研究回顾性评估了调强放疗同步放化疗治疗颈段食管鳞癌的疗效。
2004 年至 2017 年间,共纳入 36 例接受调强放疗的颈段食管癌患者。其中,Ⅰ期 1 例,Ⅲ期 3 例,ⅣA 期 19 例,ⅣB 期 13 例。所有患者均接受 60Gy 放疗及铂类为基础的双联化疗。
生存患者的中位随访时间为 36 个月。3 年局部区域控制率、无进展生存率和总生存率分别为 54%、40%和 46%。36 例患者中有 20 例(56%)出现疾病进展。4 例(3 例食管狭窄,1 例颈动脉狭窄)出现 3 级迟发性毒性。无 4-5 级毒性。单因素分析发现放疗时间是总生存率的预后因素。
调强放疗同步放化疗治疗局部晚期颈段食管癌可获得满意的局部区域控制和生存,毒性可接受。