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根治性放化疗治疗合并肝硬化的浅表性食管癌

Radical chemoradiotherapy for superficial esophageal cancer complicated with liver cirrhosis.

作者信息

Bao Hejing, Bao Hehong, Lin Liping, Wang Yuhuan, Zhang Longbin, Zhang Li, Zhang Han, Liu Lingxiang, Cao Xiaolong

机构信息

Department of Oncology, The Affiliated Panyu Center Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

Cancer Institute of Panyu, Guangzhou, China.

出版信息

PeerJ. 2024 Sep 11;12:e18065. doi: 10.7717/peerj.18065. eCollection 2024.

Abstract

BACKGROUND

Although chemoradiotherapy is an effective treatment for esophageal cancer, its feasibility in esophageal cancer with cirrhosis remains largely unclear.

METHODS

We retrospectively studied 11 patients with superficial esophageal cancer with liver cirrhosis (Child-Pugh score ≤8) who underwent radical chemoradiotherapy from four centers, and the overall survival rate, local control rate and adverse events at 1 and 3 years were explored.

RESULTS

The median age of the included patients was 67 years (Inter-Quartile Range 60-75 years). Complete response was observed in most patients ( = 10, 90.9%), and the remaining patient was unevaluable. The 1- and 3-year overall survival and local control rates were 90.9% and 90.9%, and 72.7% and 63.6%, respectively. Hematotoxicity was a common adverse reaction, and seven patients developed radiation esophagitis, with grade 3-4 observed in two cases. All cases of radiation dermatitis ( = 4) and radiation pneumonia ( = 2) were grade 1-2. Gastrointestinal bleeding occurred in two patients, including one with grade 1-2 bleeding, and one died.

CONCLUSION

Radical chemoradiotherapy is a potential treatment option for patients with superficial esophageal cancer complicated with cirrhosis. However, it can increase the risk of bleeding, which warrants prompt recognition and intervention.

摘要

背景

尽管放化疗是食管癌的有效治疗方法,但其在合并肝硬化的食管癌患者中的可行性仍不清楚。

方法

我们回顾性研究了来自四个中心的11例合并肝硬化(Child-Pugh评分≤8)的浅表性食管癌患者,这些患者接受了根治性放化疗,并探讨了其1年和3年的总生存率、局部控制率及不良事件。

结果

纳入患者的中位年龄为67岁(四分位间距60 - 75岁)。大多数患者(n = 10,90.9%)观察到完全缓解,其余1例患者无法评估。1年和3年的总生存率及局部控制率分别为90.9%和90.9%,以及72.7%和63.6%。血液毒性是常见的不良反应,7例患者发生放射性食管炎,其中2例为3 - 4级。所有放射性皮炎(n = 4)和放射性肺炎(n = 2)病例均为1 - 2级。2例患者发生胃肠道出血,其中1例为1 - 2级出血,1例死亡。

结论

根治性放化疗是合并肝硬化的浅表性食管癌患者的一种潜在治疗选择。然而,它会增加出血风险,这需要及时识别和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f06f/11401512/568bbf276203/peerj-12-18065-g001.jpg

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