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Treatment outcomes of 792 cases of esophageal carcinoma patients treated with three-dimensional radiotherapy
KONG Jie, LI Xiao-ning,HAN Chun,WANG Lan, GAO Chao, ZHANG Jing, TIAN Hua, XIAO Ai-qin, MA Guo-xin
Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China Corresponding author:HAN Chun, Email:hanchun2006@126.com
Abstract Objective To investigate the long term clinical result of three-dimensional radiotherapyfor esophageal carcinoma, discuss the effect of correlative factors to survival and local control. MethodsFrom July 2003 to December 2008, 792 patients with esophageal cancer were eligible. Patients were treated with three-dimensional radiotherapy (672 patients) or intensity-modulated (120 patients) radiotherapy. The radiotherapy was delivered in 1.8－2.0 Gy per fraction, 5 fractions per week, total dose of 50－70 Gy,(median, 60 Gy). 142 patients were treated by concurrent radiochemotherapy, and the other 650 patients radiotherapy alone. The local control rate and survival rate were calculated by Kaplan-Meier method. Logrank method was used for univariate analyses. Cox regression model was used for multivariate analyses. Results The follow-up rate was 95.8%.The number of patients with 5 years time followed-up was 133.The 1-year, 3-year and 5-year local control rates were 76.6%, 53.2%, 48.6%, and the 1-year, 3-year and 5-year overall survival rates were 70.1%, 36.7% and 28.0%, respectively. There were significant influence on the prognosis of T stage, N stage, TNM stage, tumor volume (χ2=20.58－55.60,all P=0.000). The Cox multivariate model showed that N stage and tumor volume were independent prognostic factors (χ2=6.35,29.23,P=0.012,0.000). For the two groups of concurrent chemo-radiotherapy and radiotherapy alone, 5-year local control rates were 57.0% and 46.8%(χ2=7.34,P=0.007),the 5-year overall survival rate 32.8% and 27.6%(χ2=3.42,P=0.064. Conclusions Three-dimensional radiotherapy is effective for esophageal carcinoma. It might improve the local control rate and overall survival rate to some extent. T staging, N staging, TNM staging and tumor volume were important prognostic factors for long-term survival. The addition of concurrent radiochemotherapy could improve local control rates.
KONG Jie,LI Xiao-ning,HAN Chun et al. Treatment outcomes of 792 cases of esophageal carcinoma patients treated with three-dimensional radiotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(5): 421-422.
KONG Jie,LI Xiao-ning,HAN Chun et al. Treatment outcomes of 792 cases of esophageal carcinoma patients treated with three-dimensional radiotherapy[J]. Chinese Journal of Radiation Oncology, 2012, 21(5): 421-422.
[1] Bedford JL, Viviers L, Guzel Z, et al. A quantitative treatment planning study evaluating the potential of dose escalation in conformal radiotherapy of the oesophagus. Radiother Oncol,2000,57:183-193. [2] 韩春,王澜,祝淑钗,等.非手术治疗食管癌临床分期标准对 225例放疗患者的预后评价.中华放射肿瘤学杂志,2011,20:109-112. [3] 中国非手术治疗食管癌临床分期专家小组.非手术治疗食管癌的临床分期标准(草案).中华放射肿瘤学杂志,2010,19:179-180. [4] 殷蔚伯,张力军,杨宗贻,等.放射治疗食管癌 3798例临床分析.中华肿瘤杂志,1980,3:216-220. [5] 朱孝贞,尹淑玲,陈秋立,等.2722例食管癌放疗分析.中国放射肿瘤学,1988,2:18-19. [6] Cooper JS, Guo MD, Herskovic A, et al. Chemoradiotherapy of locally advanced esophageal cancer:long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA,1999,281:1623-1627. [7] Kato K, Muro K, Minashi K, et al. Phase Ⅱ study of chemoradiotherapy with 5-fluorouracil and cisplatin for stage Ⅱ－Ⅲ Esophageal squamous cell carcinoma:JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys,2011,81:684-690. [8] 刘俊,吕长兴,王家明.同步放化疗治疗不能手术的食管癌临床结果.中华放射肿瘤学杂志,2006,15:185-187. [9] 王澜,韩春,李晓宁,等.中晚期食管癌三维适形放疗联合同期化疗的临床观察.中华肿瘤防治杂志,2010,17:2053-2056. [10] Yamada K, Murakami M, Okamoto Y, et al. Treatment results of chemoradiotherapy for clinical stage Ⅰ (T1N0M0) esophageal carcinoma. Int J Radiat Oncol Biol Phys,2006,64:1106-1111.
2012, Vol. 21 
