Zhou Shixiang, Yang Yan, Zhang Qun, Zhu Chaomang, Cai Peng, Li Duojie
Department of Radiotherapy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Anhui Province Key Laboratory of Translational Cancer Research, Bengbu Medical College, Bengbu, China.
Ann Transl Med. 2023 Jan 31;11(2):103. doi: 10.21037/atm-22-6462.
Esophageal cancer is one of the most common malignant tumors in China. Patients with advanced esophageal cancer often cannot be treated by surgery; in these cases, radiation therapy is usually applied. However, there are currently few studies on the clinical efficacy of this treatment method. The present study aimed to investigate and observe the clinical efficacy and related prognostic factors of simultaneous integrated boost-intensity modulated radiation therapy (SIB-IMRT) in esophageal squamous carcinoma, and to provide a reference for clinicians in radiotherapy (RT) departments.
The clinical and follow-up data of 220 patients with esophageal squamous carcinoma admitted to the First Affiliated Hospital of Bengbu Medical College from January 2017 to December 2018 were retrospectively analyzed to assess the relevant prognostic factors and analyze their effects on 3-year overall survival (OS) and progression-free survival (PFS). The prognostic influencing factors were analyzed using the log-rank test and Cox multi-factor regression analysis.
The median follow-up time was 56.0 months (3.0 to 66.0 months). The 1-, 2-, and 3-year survival rates were 68.6%, 49.1%, and 36.3%, respectively, for the entire cohort, and the 1-, 2-, and 3-year PFS rates were 52.3%, 37.7%, and 25.5%, respectively. The median OS time was 24 months [95% confidence interval (CI): 19.16-28.84 months] and the median PFS time was 15 months (95% CI: 11.04-18.96 months). The multifactorial analysis results showed that gender, RT dose, treatment modality, absolute lymphocyte count (ALC), and gross tumor volume (GTV) were independent prognostic factors affecting 3-year OS (P<0.05); while gender, N-stage, RT dose, and GTV were independent prognostic factors affecting 3-year PFS (P<0.05).
In the SIB-IMRT era, the survival of esophageal squamous cell carcinoma (ESCC) patients treated with radical (chemo)radiotherapy is relatively satisfactory. As a single-institution study on radiation therapy for esophageal cancer, this study yielded accurate results that help to provide references for subsequent related studies and clinicians' selection of treatment options.
食管癌是中国最常见的恶性肿瘤之一。晚期食管癌患者往往无法接受手术治疗；在这些情况下，通常采用放射治疗。然而，目前关于这种治疗方法临床疗效的研究较少。本研究旨在探讨和观察同步整合加量调强放射治疗（SIB-IMRT）在食管鳞状细胞癌中的临床疗效及相关预后因素，为放疗科临床医生提供参考。
回顾性分析2017年1月至2018年12月蚌埠医学院第一附属医院收治的220例食管鳞状细胞癌患者的临床及随访资料，评估相关预后因素，并分析其对3年总生存（OS）和无进展生存（PFS）的影响。采用log-rank检验和Cox多因素回归分析对预后影响因素进行分析。
中位随访时间为56.0个月（3.0至66.0个月）。整个队列的1年、2年和3年生存率分别为68.6%、49.1%和36.3%，1年、2年和3年PFS率分别为52.3%、37.7%和25.5%。中位OS时间为24个月[95%置信区间（CI）：19.16 - 28.84个月]，中位PFS时间为15个月（95%CI：11.04 - 18.96个月）。多因素分析结果显示，性别、放疗剂量、治疗方式、绝对淋巴细胞计数（ALC）和肿瘤总体积（GTV）是影响3年OS的独立预后因素（P<0.05）；而性别、N分期、放疗剂量和GTV是影响3年PFS的独立预后因素（P<0.05）。
在SIB-IMRT时代，接受根治性（化疗）放疗的食管鳞状细胞癌（ESCC）患者的生存情况相对令人满意。作为一项关于食管癌放射治疗的单机构研究，本研究得出了准确的结果，有助于为后续相关研究及临床医生选择治疗方案提供参考。
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