Boustani J, Créhange G
Département de radiothérapie, Centre hospitalo-universitaire de Besançon, Besançon, France.
Département de radiothérapie, Institut Curie, Paris, France.
Cancer Radiother. 2022 Oct;26(6-7):884-889. doi: 10.1016/j.canrad.2022.06.021. Epub 2022 Aug 23.
For non-operable, localized esophageal cancer, definitive concurrent chemoradiotherapy is the standard treatment. Currently, the radiation dose recommended is 50 to 50,4Gy. However, the optimal radiation dose remains controversial. Many studies have demonstrated that locoregional failure remains a common failure pattern, most likely to occur within the original gross tumor volume. Several retrospective studies have indicated that higher radiation dose may improve local control and survival while others failed to demonstrate improved oucomes. In three randomized trials (INT0123, ARTDECO, and CONCORDE), dose escalation did not improve locoregional control nor survival, establishing 50Gy as the standard chemoradiation dose for patients who will not undergo surgery. Here, we reviewed the results of dose escalation in the literature in the neoadjuvant and definitive settings.
对于不可手术的局限性食管癌,根治性同步放化疗是标准治疗方法。目前,推荐的放疗剂量为50至50.4Gy。然而,最佳放疗剂量仍存在争议。许多研究表明,局部区域复发仍然是常见的复发模式,最有可能发生在原发大体肿瘤体积内。几项回顾性研究表明,更高的放疗剂量可能改善局部控制和生存率,而其他研究未能证明有更好的结果。在三项随机试验(INT0123、ARTDECO和CONCORDE)中,剂量递增并未改善局部区域控制或生存率,确立了50Gy作为不接受手术患者的标准放化疗剂量。在此,我们回顾了新辅助和根治性治疗中剂量递增在文献中的结果。