食管癌扩大野与累及野3DRT的<i>Meta分析</i>

doi:10.3760/cma.j.issn.1004-4221.2016.09.003

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Abstract Objective To investigate the therapeutic effects, adverse effects, and patterns of failure of elective irradiation of lymphatic drainage area (extended-field) and involved-field irradiation in three-dimensional radiotherapy (3DRT) in patients with esophageal cancer via a Meta-analysis. Methods The databases Wanfang Data, CNKI, VIP, CBM, PubMed, Embase, and Cochrane Library were searched to collect the controlled clinical trials on extended-field irradiation and involved-field irradiation in 3DRT in patients with esophageal cancer. Stata 11.0 was used for data analysis. The odds ratio (OR) with 95% confidence interval was used to describe the differences between two groups. Results According to the inclusion and exclusion criteria, a total of 12 controlled clinical trials involving 1 095 patients with esophageal cancer were included in this meta-analysis. The results of the meta-analysis showed that compared with the involved-field irradiation group, the extended-field irradiation group had a significantly reduced rate of out-field failure in patients with esophageal cancer who received 3DRT (OR=3.727, P=0.007), but showed significantly higher rates of grade ≥3 acute radiation pneumonitis and radiation esophagitis (acute radiation pneumonitis:OR=0.348, P=0.001;radiation esophagitis:OR=0.385, P=0.000). The two groups had similar 1-, 2-, and 3-year local control rate and overall survival rate (local control rate:OR=0.966/0.946/0.732, P=0.837/0.781/0.098;overall survival rate:OR=0.952/1.149/0.768, P=0.756/0.422/0.120), as well as a similar distant metastasis rate (OR=0.986, P=0.937). Conclusions Compared with involved-field irradiation, extended-field irradiation can reduce the rate of out-field failure in patients with esophageal cancer who receive 3DRT. However, it does not have significant advantages in local control rate and overall survival rate and has an increased incidence rate of adverse effects.

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	Articles by authors
	Bai Wenwen
	Zhou Zhiguo
	Zhang Ruohui
	Song Yuzhi
	Zhen Chanjun
	Qiao Xueying

Key words： Esophageal neoplasms/three-dimensional radiotherapy Three-dimensional radiotherapy elective nodal Three-dimensional radiotherapy involved-field Meta-analysis

Received: 10 August 2015

Corresponding Authors: Qiao Xueying,Email:xueying_qiao@126.com

Cite this article:

Bai Wenwen,Zhou Zhiguo,Zhang Ruohui et al. Therapeutic effects of extended-field and involved-field irradiation in three-dimensional radiotherapy in patients with esophageal cancer:a meta-analysis[J]. Chinese Journal of Radiation Oncology, 2016, 25(9): 923-928.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.09.003 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I9/923

[1] 王澜,孔洁,韩春,等.781例不同部位食管癌三维放疗预后分析[J].中华放射肿瘤学杂志,2013,22(1):18-21.DOI:10.3760/cma.j.issn.1004-4221.2013.01.006.
Wang L,Kong J,Han C,et al. Prognostic analysis of cervical,upper-thoracic,middle-thoracic,and lower-thoracic esophageal cancers in 781 patients mainly receiving three-dimensional radiotherapy[J].Chin J Radiat Oncol,2013,22(1):18-21.DOI:10.3760/cma.j.issn.1004-4221.　2013.01.006.
[2] Onozawa M,Nihei K,Ishikura S,et al. Elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for squamous cell carcinoma of the thoracic esophagus[J].Radiother Oncol,2009,92(2):266-269.DOI:10.1016/j.radonc.2008.09.025.
[3] Yamashita H,Okuma K,Wakui R,et al. Details of recurrence sites after elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT) combined with chemotherapy for thoracic esophageal squamous cell carcinoma–a retrospective analysis[J].Radiother Oncol,2011,98(2):255-260.DOI:10.1016/j.radonc.2010.10.021.
[4] Ma JB,Song YP,Yu JM,et al. Feasibility of involved-field conformal radiotherapy for cervical and upper-thoracic esophageal cancer[J].Onkologie,2011,34(11):599-604.DOI:10.1159/000334194.
[5] 张萍,谢聪颖,吴式琇.紫杉醇联合铂类与放疗同步治疗局部晚期食管癌的临床研究[J].中华肿瘤杂志,2007,29(10):773-777.DOI:10.3760/j.issn:0253-3766.2007.10.013.
Zhang P,Xie CY,Wu SX.Concurrent chemoradiation with paclitaxel and platinum for locally advanced esophageal cancer[J].Chin J Oncol,2007,29(10):773-777.DOI:10.3760/j.issn:0253-3766.2007.10.013.
[6] 臧茹琨,马金波,宋轶鹏,等.中胸段食管癌累及野与淋巴结选择性照射对比研究[J].中华肿瘤防治杂志,2013,20(24):1917-1920.DOI:10.3969/j.issn.1673-5269.2013.24.013.
Zang RK,Ma JB,Song YP,et al. Comparation of involved-field conformal irradiation and elective nodal irradiation for middle-thoracic esophageal cancer[J].Chin J Cancer Prev Treat,2013,20(24):1917-1920.DOI:10.3969/j.issn.1673-5269.2013.24.013.
[7] 周志国,乔学英,高献书,等.食管癌三维适形放疗临床靶体积研究[J].中华放射肿瘤学杂志,2009,18(2):86-87.DOI:10.3760/cma.j.issn.1004-4221.2009.02.086.
Zhou ZHG,Qiao XY,Gao XSH,et al. Three dimensional conformal radiotherapy for esophageal cancer:a clinical study of target volume[J].Chin J Radiat Oncol,2009,18(2):86-87.DOI:10.3760/cma.j.issn.1004-4221.2009.02.086.
[8] 李曼,乔学英,周志国,等.胸段食管癌三维适形放疗临床靶体积前瞻性随机临床研究[J].中国肿瘤临床,2012,39(17):1294-1298.DOI:10.3969/j.issn.1000-8179.2012.17.008.
Li M,Qiao XY,Zhou ZG,et al. A prospectively randomized study of clinical target volume margins for three-dimensional conformal radiotherapy in patients with thoracic esophageal squamous cell carcinoma[J].Chin J Clin Oncol,2012,39(17):1294-1298.DOI:10.3969/j.issn.1000-8179.2012.17.008.
[9] 董辉,祝淑钗,苏景伟,等.食管癌根治性放疗中ENI与IFI失败模式研究[J].中华放射肿瘤学杂志,2014,23(6):479-483.DOI:10.3760/cma.j.issn.1004-4221.2014.06.005.
Dong H,Zhu SC,Su JW,et al. A comparative study of failure patterns of definitive treatment of esophageal cancer with elective nodal irradiation and involved-field irradiation[J].Chin J Radiat Oncol,2014,23(6):479-483.DOI:10.3760/cma.j.issn.1004-4221.2014.06.005.
[10] 舒中琴,于波,顾小伟,等.食管癌三维适形放疗不同靶区勾画的临床观察[J].实用临床医药杂志,2010,14(21):146-147.DOI:10.3969/j.issn.1672-2353.2010.21.076.
Shu ZHQ,Yu B,Gu XW,et al. Clinical observation of three dimensional conformal radiotherapy for esophageal carcinoma with different target areas[J].J Pract Clin Med,2010,14(21):146-147.DOI:10.3969/j.issn.1672-2353.2010.21.076.
[11] 李多杰,李红伟,何斌,等.食管癌适形调强放疗累及野和扩大野的比较研究[J].中国肿瘤临床,2013,40(20):1248-1251.DOI:10.3969/j.issn.1000-8179.20130671.
Li DJ,Li HW,He B,et al. Comparison of involved field radiotherapy and extended field ra-diotherapy of definitive radiotherapy in patients with esophageal squamous cell carcinoma[J].Chin J Clin Oncol,2013,40(20):1248-1251.DOI:10.3969/j.issn.1000-8179.20130671.
[12] 周超,杨海华,胡炜,等.局部晚期食管癌扩大野同期放化疗的临床研究[J].中华放射肿瘤学杂志,2012,21(6):522-525.DOI:10.3760/cma.j.issn.1004-4221.2012.06.011.
Zhou C,Yang HH,Hu W,et al. Clinical research of extensive regional field radiotherapy concurrent with chemotherapy for locally advanced esophageal cancer[J].Chin J Radiat Oncol,2012,21(6):522-525.DOI:10.3760/cma.j.issn.1004-4221.2012.06.011.
[13] 赵兵,金永,李再芹,等.不同放疗靶区对食管癌疗效及安全性的影响[J].现代肿瘤医学,2015,23(4):480-483.DOI:10.3969/j.issn.1672-4992.2015.04.13.
Zhao B,Jin Y,Li ZQ,et al. Effect and safety of different radiotherapy target region on the therapeutic effect of esophageal carcinoma[J].J Mod Oncol,2015,23(4):480-483.DOI:10.3969/j.issn.1672-4992.2015.04.13.
[14] 孙荣刚,张光斌,任润川.局部晚期食管癌累积野照射与选择淋巴引流区照射对照研究[J].临床医学,2014,34(8):18-19.
Sun RG,Zhang GB,Ren RC.Comparative study of involved field radiotherapy and selected lymphatic drainage field radiotherapy for local advanced esophageal cancer[J].Clin Med,2014,34(8):18-19.
[15] 姚钧,孙小兵.食管癌三维适形放疗淋巴引流区预防照射与累及野照射疗效比较[J].山东医药,2015,55(14):94-95.DOI:10.3969/j.issn.1002-266X.2015.14.037.
Yao J,Sun XB.Comparison of three dimensional conformal radiotherapy for the prevention of radiation and the involvement of the field of radiation in the lymph drainage area of esophageal cancer[J].Shandong Med J,2015,55(14):94-95.DOI:10.3969/j.issn.1002-266X.2015.14.037.
[16] Tachibana M,Kinugasa S,Yoshimura H,et al. Clinical outcomes of extended esophagectomy with three-field lymph node dissection for esophageal squamous cell carcinoma[J].Am J Surg,2005,189(1):98-109.DOI:10.1016/j.amjsurg.2004.10.001.
[17] 汪杰华,李晓丽,陈赟,等.食管癌三维3DRT时采用累及野照射的失败模式[J].中国癌症杂志,2012,22(8):601-604.DOI:10.3969/j.issn.1007-3969.2012.08.008.
Wang JH,Li XL,Chen Y,et al. Patterns of failure associated with involved field after definitive radiotherapy for squamous cell carcinoma of the esophagus[J].China Oncol,2012,22(8):601-604.DOI:10.3969/j.issn.1007-3969.　2012.　08.008.
[18] Gao XS,Qiao XY,Wu FP,et al. Pathological analysis of clinical target volume margin for radiotherapy in patients with esophageal and gastroesophageal junction carcinoma[J].Int J Radiat Oncol Biol Phys,2007,67(2):389-396.DOI:10.1016/j.ijrobp.2006.09.015.
[19] 王俊超,李涛,张军.食管癌三维适形放疗临床靶体积对预后影响的Meta分析[J].循证医学,2012,12(6):363-367.DOI:10.3969/j.issn.1671-5144.2012.06.010.
Wang JC,Li T,Zhang J.Meta-analysis of the effect of clinical target volume for three dimensional conformal radiotherapy for the treatment of esophageal carcinoma[J].J Evid-Based Med,2012,12(6):363-367.DOI:10.3969/j.issn.1671-5144.2012.06.010.