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Research advances in postoperative radiotherapy for esophageal squamous cell carcinoma
Luo Yijun,Li Minghuan,Zhu Yingming,Yu Jinming
School of Medicine and Life Sciences,Shandong Academy of Medical Sciences,University of Jinan,Ji’nan 250022,China (Luo YJ);Department of Radiotherapy,Shandong Cancer Hospital,Ji’nan 250117,China (Luo YJ,Li MH,Zhu YM,Yu JM)
Abstract Surgery remains an important therapeutic method for localized esophageal cancer, but the 5-year survival rate of patients undergoing surgical resection alone is only 20%-25%. Early studies show that postoperative radiotherapy reduced regional recurrence rate, but did not increase the survival rate. Most recent studies show that stage Ⅲ or lymph node-positive patients can obtain survival benefit from postoperative radiotherapy, and patients in pT2-3N0M0 stage may also benefit from postoperative radiotherapy. The recommended radiotherapy target volumes include bilateral supraclavicular areas, superior mediastinum, subcarinal area, and tumor bed. It is recommended in most studies that regional lymph nodes in the upper abdomen should be included in patients with lower-segment lesions. The locally advanced patients may benefit more from postoperative radiotherapy combined with chemotherapy. The significance of postoperative radiotherapy for esophageal squamous cell carcinoma, target volume design, and combined chemotherapy need individualized consideration and more clinical evidence.
Luo Yijun,Li Minghuan,Zhu Yingming et al. Research advances in postoperative radiotherapy for esophageal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(8): 891-894.
Luo Yijun,Li Minghuan,Zhu Yingming et al. Research advances in postoperative radiotherapy for esophageal squamous cell carcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(8): 891-894.
[1] Torre LA,Bray F,Siegel RL,et al. Global cancer statistics,2012[J].CA A Cancer J Clin,2015,65(2):87-108.DOI:10.3322/caac.21262 [2] Almhanna K,Shridhar R,Meredith KL.Neoadjuvant or adjuvant therapy for resectable esophageal cancer:is there a standard of care?[J].Cancer Control,2013,20(2):89-96 [3] DeVita Jr VT,Lawrence TS,Rosenberg SA,et al. Cancer:principles and practice of oncology[M].9th ed. Philadelphia:Lippincott Williams& Wilkins,2011:893 [4] Hulscher JBF,van Sandick JW,Tijssen JGP,et al. The recurrence pattern of esophageal carcinoma after transhiatal resection[J].J Am Coll Surg,2000,191(2):143-148.DOI:10.1016/S1072-7515(00)00349-5 [5] Kasai M,Mori S,Watanabe T.Follow-up results after resection of thoracic esophageal carcinoma[J].World J Surg,1978,2(4):543-549.DOI:10.1007/BF01563699 [6] Ténière P,Hay JM,Fingerhut A,et al. Postoperative radiation therapy does not increase survival after curative resection for squamous cell carcinoma of the middle and lower esophagus as shown by a multicenter controlled trial. French university association for surgical research[J].Surg Gynecol Obstet,1991,173(2):123-130 [7] Fok M,Sham JST,Choy D,et al. Postoperative radiotherapy for carcinoma of the esophagus:a prospective,randomized controlled study[J].Surgery,1993,113(2):138-147 [8] Zieren HU,Müller JM,Jacobi CA,et al. Adjuvant postoperative radiation therapy after curative resection of squamous cell carcinoma of the thoracic esophagus:a prospective randomized study[J].World J Surg,1995,19(3):444-449.DOI:10.1007/BF00299187 [9] Malthaner RA,Wong RKS,Rumble RB,et al. Neoadjuvant or adjuvant therapy for resectable esophageal cancer:a systematic review and meta-analysis[J].BMC Med,2004,2:35.DOI:10.1186/1741-7015-2-35 [10] Schreiber D,Rineer J,Vongtama D,et al. Impact of postoperative radiation after esophagectomy for esophageal cancer[J].J Thorac Oncol,2010,5(2):244-250.DOI:10.1097/JTO.0b013e3181c5e34f [11] Liu Q,Cai XW,Wu B,et al. Patterns of failure after radical surgery among patients with thoracic esophageal squamous cell carcinoma:implications for the clinical target volume design of postoperative radiotherapy[J].PLoS One,2014,9(5):e97225.DOI:10.1371/journal.pone.0097225 [12] Xiao ZF,Yang ZY,Liang J,et al. Value of radiotherapy after radical surgery for esophageal carcinoma:a report of 495 patients[J].Ann Thorac Surg,2003,75(2):331-336.DOI:10.1016/S0003-4975(02)04401-6 [13] Chen JQ,Pan JJ,Zheng XW,et al. Number and location of positive nodes,postoperative radiotherapy,and survival after esophagectomy with three-field lymph node dissection for thoracic esophageal squamous cell carcinoma[J].Int J Radiat Oncol Biol Phys,2012,82(1):475-482.DOI:10.1016/j.ijrobp.2010.08.037 [14] Chen JQ,Zhu J,Pan JJ,et al. Postoperative radiotherapy improved survival of poor prognostic squamous cell carcinoma esophagus[J].Ann Thorac Surg,2010,90(2):435-442.DOI:10.1016/j.athoracsur.2010.04.002 [15] Xu YP,Liu JS,Du XH,et al. Prognostic impact of postoperative radiation in patients undergoing radical esophagectomy for pathologic lymph node positive esophageal cancer[J].Radiat Oncol,2013,8:116.DOI:10.1186/1748-717X-8-116 [16] 杨劲松,刘晓,肖泽芬,等.pT2-3N0M0期食管癌根治术后3DRT前瞻性Ⅱ期临床研究[J].中华放射肿瘤学杂志,2015,24(1):29-32.DOI:10.3760/cma.j.issn.1004-4221.2015.01.008 Yang JS,Liu X,Xiao ZF,et al.3DRT prospective phase Ⅱ clinical study in patients with stage pT2-3N0M0 esophageal cancer after radical operation[J].Chin J Radiat Oncol,2015,24(1):29-32.DOI:10.3760/cma.j.issn.1004-4221.2015.01.008 [17] 刘晓,章文成,于舒飞,等.T2-3N0M0期食管癌R0术后失败模式分析——术后放疗潜在价值与意义[J].中华放射肿瘤学杂志,2015,24(1):19-24.DOI:10.3760/cma.j.issn.1004-4221.2015.01.006 Liu X,Zhang WCH,Yu SHF,et al. Failure mode analysis of T2-3N0M0 esophageal carcinoma after R0 operation:potential value and significance of postoperative radiotherapy[J].Chin J Radiat Oncol,2015,24(1):19-24.DOI:10.3760/cma.j.issn.1004-4221.2015.01.006 [18] Lu JC,Tao H,Zhang YQ,et al. Extent of prophylactic postoperative radiotherapy after radical surgery of thoracic esophageal squamous cell carcinoma[J].Dis Esophagus,2008,21(6):502-507.DOI:10.1111/j.1442-2050.2007.00797.x [19] Qiao XY,Wang W,Zhou ZG,et al. Comparison of efficacy of regional and extensive clinical target volumes in postoperative radiotherapy for esophageal squamous cell carcinoma[J].Int J Radiat Oncol Biol Phys,2008,70(2):396-402.DOI:10.1016/j.ijrobp.2007.07.1301 [20] 陈俊强,陈明强,李云英,等.胸段食管癌三野根治术后放疗靶区的临床研究[J].中华放射医学与防护杂志,2006,26(4):374-377.DOI:10.3760/cma.j.issn.0254-5098.2006.04.020 Chen JQ,Cheng MQ,Li YY,et al. Clinical study on the target area of radiotherapy for thoracic esophageal cancer after Mino Genji surgery[J].Chin J Radiol Med Protect,2006,26(4):374-377.DOI:10.3760/cma.j.issn.0254-5098.2006.04.020 [21] 陈雅云,蔡文杰,辛培玲.胸段食管癌术后预防照射靶区的最优尺度分析[J].中国医药指南,2013,11(24):402-404 Chen YY,Cai WJ,Xin PL.Optimal scale analysis of the prevention of radiation target area after the operation of thoracic esophageal cancer[J].Chin Med Guid,2013,11(24):402-404 [22] Li CL,Zhang FL,Wang YD,et al. Characteristics of recurrence after radical esophagectomy with two-field lymph node dissection for thoracic esophageal cancer[J].Oncol Lett,2013,5(1):355-359.DOI:10.3892/ol.2012.946 [23] Lee SJ,Lee KS,Yim YJ,et al. Recurrence of squamous cell carcinoma of the oesophagus after curative surgery:rates and patterns on imaging studies correlated with tumour location and pathological stage[J].Clin Radiol,2005,60(5):547-554.DOI:10.1016/j.crad.2004.09.002 [24] Cai WJ,Xin PL.Pattern of relapse in surgical treated patients with thoracic esophageal squamous cell carcinoma and its possible impact on target delineation for postoperative radiotherapy[J].Radiother Oncol,2010,96(1):104-107.DOI:10.1016/j.radonc.2010.04.029 [25] 章文成,王奇峰,肖泽芬,等.胸段食管鳞癌根治术后失败模式对放疗野设计的指导作用[J].中华放射肿瘤学杂志,2012,21(1):38-41.DOI:10.3760/cma.j.issn.1004-4221.2012.01.012 Zhang WCH,Wang QF,Xiao ZF,et al. The guiding effect of failure mode of thoracic esophageal squamous cell carcinoma after radical operation on the field of radiotherapy[J].Chin J Radiat Oncol,2012,21(1):38-41.DOI:10.3760/cma.j.issn.1004-4221.2012.01.012 [26] 戴明明,吴三纲,郑华,等.胸段食管鳞癌根治术后区域淋巴结的复发模式[J].世界华人消化杂志,2014,22(28):4237-4242 Dai MM,Wu SG,Zheng H,et al. Recurrence pattern of regional lymph nodes after radical resection of thoracic esophageal squamous cell carcinoma[J].World J Chin,2014,22(28):4237-4242 [27] Zheng B,Zheng W,Zhu Y,et al. Role of adjuvant chemoradiotherapy in treatment of resectable esophageal carcinoma:a meta-analysis[J].Chin Med J (Engl),2013,126(6):1178-1182 [28] 陈俊强,潘建基,李建成,等.淋巴结阳性胸段食管鳞癌术后放化疗临床研究[J].中华放射肿瘤学杂志,2011,20(4):287-290.DOI:10.3760/cma.j.issn.1004-4221.2011.04.008 Chen JQ,Pan JJ,Li JCH,et al. Clinical study of postoperative radiotherapy and chemotherapy in patients with positive lymph node positive thoracic esophageal squamous cell carcinoma[J].Chin J Radiat Oncol,2011,20(4):287-290.DOI:10.3760/cma.j.issn.1004-4221.2011.04.008 [29] Chen JQ,Pan JJ,Liu J,et al. Postoperative radiation therapy with or without concurrent chemotherapy for node-positive thoracic esophageal squamous cell carcinoma[J].Int J Radiat Oncol Biol Phys,2013,86(4):671-677.DOI:10.1016/j.ijrobp.2013.03.026 [30] Doki Y,Ishikawa O,Takachi K,et al. Association of the primary tumor location with the site of tumor recurrence after curative resection of thoracic esophageal carcinoma[J].World J Surg,2005,29(6):700-707.DOI:10.1007/s00268-005-7596-4 [31] Amini A,Xiao LC,Allen PK,et al. Celiac node failure patterns after definitive chemoradiation for esophageal cancer in the modern era[J].Int J Radiat Oncol Biol Phys,2012,83(2):e231-e239.DOI:10.1016/j.ijrobp.2011.12.061
2016, Vol. 25 
