National Institutes for Quantum Science and Technology, QST Hospital, Chiba, Japan.
Department of Radiology, QST Hospital, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan.
Esophagus. 2024 Oct;21(4):523-529. doi: 10.1007/s10388-024-01067-7. Epub 2024 May 30.
A recent phase I/II study determined the optimal dose of definitive carbon-ion radiotherapy (CIRT) for cT1bN0M0 esophageal cancer. This study aimed to further confirm the efficacy and feasibility of the recommended dose fractionation of CIRT with long-term follow-up results in a larger sample size.
This single center retrospective study evaluated patients with cT1bN0M0 esophageal squamous cell carcinoma treated with the recommended dose fractionation of 50.4 Gy relative biological effectiveness in 12 fractions, between 2012 and 2022.
Thirty-eight patients underwent CIRT at our hospital. Although eight (21.1%) patients were older than 80 years, 15 (39.5%) had high surgical risk, and seven (18.4%) were at high risk for chemotherapy, all patients underwent CIRT as scheduled. Grade 3 esophagitis occurred in eight (21.1%) patients and grade 3 pneumonia in one (2.6%) patient in this study, but no grade 4 adverse events occurred. The only grade 3 late adverse event was pneumonia in one patient (2.6%). The 5-year overall survival rate, local control rate, and disease-free survival rates were 76.6% (95% CI, 90.9-62.4), 74.9% (95% CI, 90.7-59.0), and 66.4% (95% CI, 83.3-49.5), respectively. Additionally, post CIRT recurrence was as follows: seven (18.4%) patients had recurrence in another part of the esophagus, three (7.9%) in the primary site, three (7.9%) in lymph nodes outside the irradiated area, and one (2.6%) patient had liver metastasis.
Our study demonstrates that CIRT using the recommended dose fractionation is feasible and effective for cT1bN0M0 esophageal squamous cell carcinoma.
最近的一项 I/II 期研究确定了根治性碳离子放疗（CIRT）治疗 cT1bN0M0 食管癌的最佳剂量。本研究旨在通过更大样本量的长期随访结果，进一步证实推荐剂量分割的 CIRT 的疗效和可行性。
本单中心回顾性研究评估了 2012 年至 2022 年间，接受推荐剂量分割（50.4Gy 相对生物效应，12 次分割）碳离子放疗的 cT1bN0M0 食管鳞状细胞癌患者的情况。
38 例患者在我院行 CIRT 治疗。尽管有 8 例（21.1%）患者年龄大于 80 岁，15 例（39.5%）有较高的手术风险，7 例（18.4%）有化疗高危因素，但所有患者均按计划行 CIRT 治疗。本研究中，8 例（21.1%）患者发生 3 级食管炎，1 例（2.6%）患者发生 3 级肺炎，但无 4 级不良事件发生。唯一的 3 级晚期不良事件是 1 例（2.6%）患者发生肺炎。5 年总生存率、局部控制率和无疾病生存率分别为 76.6%（95%CI，90.9-62.4）、74.9%（95%CI，90.7-59.0）和 66.4%（95%CI，83.3-49.5）。此外，CIRT 后复发情况如下：7 例（18.4%）患者食管其他部位复发，3 例（7.9%）患者原发病灶复发，3 例（7.9%）患者照射野外淋巴结复发，1 例（2.6%）患者肝转移。
本研究表明，采用推荐剂量分割的 CIRT 治疗 cT1bN0M0 食管鳞状细胞癌是可行且有效的。
