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133例Ⅳ期食管癌的临床回顾性分析
郭俊俊1, 高巍2, 王蒨1, 付神波1, 习攀1
1陕西省肿瘤医院放疗科,西安 710061; 2陕西省肿瘤医院胸外科,西安 710061
Retrospective clinical analysis of 133 cases of stage Ⅳ esophageal cancer
Guo Junjun1, Gao Wei2, Wang Qian1, Fu Shenbo1, Xi Pan1
1Department of Radiation Oncology,Shaanxi Provincial Cancer Hospital,Xi′an 710061,Shaanxi,China; 2Department of Thoracic Surgery,Shaanxi Provincial Cancer Hospital,Xi′an 710061,Shaanxi,China
Abstract:Objective To investigate the clinical significance of radiotherapy for stage Ⅳ esophageal cancer. Methods Clinical data of 133 stage Ⅳ esophageal cancer patients admitted to our hospital from 2012 to 2018 were retrospectively analyzed. All patients were assigned into the radiochemotherapy (n=89) and chemotherapy groups (n=44). The survival analysis was performed by Kaplan-Meier method. The multivariate prognostic analysis was conducted by Cox’s regression model. Results The 1-,2-and 3-year overall survival rates of the entire cohort were 53.5%,20.4% and13.6% respectively. Cox’s regression analysis showed that gender,ECOG score,number of distant metastases,and whether the primary lesions received radiotherapy were the independent prognostic factors (all P<0.05). The 1-,2-and 3-year survival rates in the radiochemotherapy group were 61%,29% and19%, and 40%,4%,0% in the chemotherapy group,respectively. In the radiochemotherapy group, the progression-free survival (PFS) and local progression-free survival (LPFS) were 8 months and 12.6 months, significantly longer compared with 4.7 months and 5.3 months in the chemotherapy group (both P<0.05). The OS of patients receiving dose> 50Gy and ≤50Gy was 14.3 months and 8.2 months (P<0.05), 8.6 months and 2.8 months for the PFS (P<0.05), and 15.2 months and 4.7 months for the LRFS (P<0.05), respectively. The number of distant metastases and the clinical efficacy for primary lesions were the independent prognostic factors in the radiochemotherapy group (both P<0.05). Conclusion Radiotherapy can improve the clinical prognosis of patients with stage Ⅳ esophageal cancer.
Guo Junjun,Gao Wei,Wang Qian et al. Retrospective clinical analysis of 133 cases of stage Ⅳ esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(2): 102-105.
[1] Enzinger PC,Ilson DH,Kelsen DP. Chemotherapy in esophageal cancer[J]. Semin Oncol,1999,26(5 Suppl 15):12-20.
[2] Kuwano H,Nishimura Y,Oyama T,et al. Guidelines for Diagnosis and Treatment of Carcinoma of the Esophagus April 2012 edition by the Japan Esophageal Society[J]. Esophagus,2015,12(1):1-30. DOI:10.1007/s10388-014-0465-1.
[3] Ku GY. Systemic therapy for esophageal cancer:chemotherapy[J]. Chin Clin Oncol 2017,6(5):49. DOI:10.21037/cco.2017.07.06.
[4] Rustgi AK,El-Serag HB. Esophageal carcinoma[J]. N Engl J Med,2014,371(26):2499-2509. DOI:10.1056/NEJMra1314530.
[5] Lund O,Hasenkam JM,Aagaard MT,et al. Time-related changes in characteristics of prognostic significance in carcinomas of the oesophagus and cardia[J]. Br J Surg,1989,76(12):1301-1307. DOI:10.1002/bjs.1800761227.
[6] Chen Y,Liu Y,Cheng X,et al. Optimal timing of early versus delayed radiotherapy for inoperable stage Ⅳ esophageal cancer[J]. Int J Radiat Oncol Biol Phys,2017,99(1):E140-E141. DOI:10.1016/j.ijrobp.2017.06.935.
[7] Wang J,Suri JS,Allen PK,et al. Factors predictive of improved outcomes with multimodality local therapy after palliative chemotherapy for stage Ⅳ esophageal cancer[J]. Am J Clin Oncol,2016,39(3):228-235. DOI:10.1097/COC.0000000000000066.
[8] Luo Y,Mao Q,Wang X,et al. Radiotherapy for esophageal carcinoma:dose,response and survival[J]. Cancer Manag Res,2017,10(1):13-21. DOI:10.2147/CMAR. S144687.
[9] Wu SG,Xie WH,Zhang ZQ,et al. Surgery combined with radiotherapy improved survival in metastatic esophageal cancer in a surveillance epidemiology and end results population-based study[J]. Sci Rep,2016,6:28280. DOI:10.1038/srep28280.
[10] Van Daele E,Scuderi V,Pape E,et al. Long-term survival after multimodality therapy including surgery for metastatic esophageal cancer[J]. Acta Chir Belg,2018,118(4):227-232. DOI:10.1080/00015458.2017.1411557.
[11] Iwase H,Shimada M,Nakamura M,et al. Concurrent chemoradiotherapy for locally advanced and metastatic esophageal cancer:longterm results of a phase Ⅱ study of UFT/CDDP with radiotherapy[J]. Int J Clin Oncol,2003,8(5):305-311. DOI:10.1007/s10147-003-0344-6.
[12] Zhang R,Jia M,Li P,et al. Radiotherapy improves the survival of patients with metastatic esophageal squamous cell carcinoma:a propensity score matched analysis of surveillance,epidemiology,and end results database[J]. Dis Esophagus,2019,32(1):1-10. DOI:10.1093/dote/doy074.
[13] Lyu J,Li T,Wang Q,et al. Outcomes of concurrent chemoradiotherapy versus chemotherapy alone for stage Ⅳ esophageal squamous cell carcinoma:a retrospective controlled study[J]. Radiat Oncol,2018,13(1):233. DOI:10.1186/s13014-018-1183-y.
[14] Mizrak-Kaya D,Wang X,Harada K,et al.101 Long-term survivors who had metastatic gastroesophageal cancer and received local consolidative therapy[J]. Oncology,2017,93(4):243-248. DOI:10.1159/000475550.
[15] Li T,Lvu J,Li F,et al. Prospective randomized phase 2 study of concurrent chemoradiation therapy (CCRT) versus chemotherapy alone in stage Ⅳ esophageal squamous cell carcinoma (ESCC)[J]. Int J Radiat Oncol Biol Phys,2016,96:S1. DOI:10.1016/j.ijrobp.2016.06.020.
[16] Guttmann DM,Mitra N,Bekelman J,et al. Improved overall survival with aggressive primary tumor radiotherapy for patients with metastatic esophageal cancer[J]. J Thorac Oncol,2017,12(7):1131-1142. DOI:10.1016/j.jtho.2017.03.026.