Zhang Yuwei, Liu Zezhou, Liang Yansong, Chen Enli, Zhang Hongtao, Gao Zhen, Wang Juan
Graduate School of Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei, China.
J Contemp Brachytherapy. 2020 Dec;12(6):579-585. doi: 10.5114/jcb.2020.101691. Epub 2020 Dec 16.
To analyze factors influencing the efficacy of I seed implantation in the treatment of in-field cervical lymph node recurrence of esophageal squamous cell carcinoma (ESCC) after external beam radiation therapy.
We conducted a retrospective review of 36 patients with in-field cervical metastatic lymph nodes recurrence of esophageal squamous cell carcinoma (CML-ESCC) after external beam radiation therapy treatment, who underwent I seed implantation in our department from 2013 to 2019. Previous cumulative external irradiation dose ranged from 20 to 66 Gy (median, 60 Gy). The post-implant efficacy was evaluated by response evaluation criteria in solid tumors (RECIST) version 1.1, and an adverse event was evaluated by the Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Score (EORTC). COX proportional hazards model was used to analyze risk factors affecting effectiveness.
Among 36 patients, 31 patients (86.1%) received fluorouracil-based chemotherapy (1-6 cycles) after I seed implantation. Local control rates at 3, 6, 12, and 24 months after implantation were 51%, 30%, 30%, and 18%, respectively, with a median of 9 months (95% CI: 6.106-11.894); survival rates after 3, 6, 12, and 24 months were 55%, 41%, 22%, and 22%, respectively, with a median of 8 months (95% CI: 5.753-10.247). Multivariate analysis showed that D and short-term efficacy were independent factors related to local control and survival rate ( = 0.005, < 0.001, 0.010, < 0.001). There were 2 cases (5.6%) with grade 1 skin toxicity, 1 case (2.8%) with grade 4 skin toxicity, 3 cases (8.3%) with grade 1 mucosal ulcer, and 3 cases (8.3%) with grade 1 xerostomia.
I seed implantation as an effective salvage treatment shows definite efficacy and safety for patients with in-field cervical lymph node recurrence of ESCC after external beam radiation therapy.
分析影响¹²⁵I粒子植入治疗外照射放疗后食管鳞状细胞癌（ESCC）野内颈部淋巴结复发疗效的因素。
回顾性分析2013年至2019年在我科接受¹²⁵I粒子植入治疗的36例外照射放疗后食管鳞状细胞癌野内颈部转移性淋巴结复发（CML-ESCC）患者。既往累积外照射剂量为20至66 Gy（中位剂量60 Gy）。采用实体瘤疗效评价标准（RECIST）1.1版评估植入后疗效，采用放射肿瘤学组（RTOG）/欧洲癌症研究与治疗组织晚期放射损伤评分（EORTC）评估不良事件。采用COX比例风险模型分析影响疗效的危险因素。
36例患者中，31例（86.1%）在¹²⁵I粒子植入后接受了以氟尿嘧啶为基础的化疗（1至6周期）。植入后3、6、12和24个月的局部控制率分别为51%、30%、30%和18%，中位时间为9个月（95%CI：6.106 - 11.894）；3、6、12和24个月后的生存率分别为55%、41%、22%和22%，中位时间为8个月（95%CI：5.753 - 10.247）。多因素分析显示，D和短期疗效是与局部控制率和生存率相关的独立因素（P = 0.005，P < 0.001，P = 0.010，P < 0.001）。有2例（5.6%）发生1级皮肤毒性，1例（2.8%）发生4级皮肤毒性，3例（8.3%）发生1级黏膜溃疡，3例（8.3%）发生1级口干。
¹²⁵I粒子植入作为一种有效的挽救治疗方法，对外照射放疗后ESCC野内颈部淋巴结复发患者显示出确切的疗效和安全性。
