Clinical Results of Proton-Beam Therapy for Locoregionally Advanced Esophageal Cancer
Clinical Results of Proton-Beam Therapy for Locoregionally Advanced Esophageal Cancer
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DOI：
10.1007/s00066-010-2079-4
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发表时间：
2010-09-01
影响因子：
3.1
通讯作者：
Sakurai, Hideyuki
中科院分区：
文献类型：
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作者：
Mizumoto, Masashi;Sugahara, Shinji;Sakurai, Hideyuki
目的：评估质子束治疗局部晚期食管癌的疗效和安全性。患者和方法：受试者是51例食管癌患者，他们在1985年至2005年期间接受质子束治疗，有或没有X射线。除一人外，所有人都患有鳞状细胞癌。在51名患者中，33名接受了X射线（中位数46戈伊）和质子（中位数36 GyE）的组合作为增强。这33名患者的X射线和质子辐射联合治疗的中位总剂量为80 GyE（范围70-90 GyE）。其他18例患者单独接受质子束治疗（中位数79 GyE，范围62-98 GyE）。结果：治疗中断，由于放射性食管炎或血液毒性是不需要的任何患者。51例患者的总体5年精算生存率为21.1%，中位生存时间为20.5个月（95%置信区间10.9-30.2）。在51例患者中，40例（78%）在完成治疗后4个月内显示完全缓解，7例（14%）显示部分缓解，缓解率为92%（47/51）。51例患者5年局部控制率为38.0%，中位局部控制时间为25.5个月（95%可信区间14.6-36.3）。需要进一步的研究来确定最佳的总剂量，分割时间表，以及质子治疗与化疗的最佳组合。
Purpose: To evaluate the efficacy and safety of proton-beam therapy for locoregionally advanced esophageal cancer.Patients and Methods: The subjects were 51 patients with esophageal cancer who were treated between 1985 and 2005 using proton beams with or without X-rays. All but one had squamous cell carcinoma. Of the 51 patients, 33 received combinations of X-rays (median 46 Gy) and protons (median 36 GyE) as a boost. The median total dose of combined X-rays and proton radiation for these 33 patients was 80 GyE (range 70-90 GyE). The other 18 patients received proton-beam therapy alone (median 79 GyE, range 62-98 GyE).Results: Treatment interruption due to radiation-induced esophagitis or hematologic toxicity was not required for any patient. The overall 5-year actuarial survival rate for the 51 patients was 21.1% and the median survival time was 20.5 months (95% confidence interval 10.9-30.2). Of the 51 patients, 40 (78%) showed a complete response within 4 months after completing treatment and seven (14%) showed a partial response, giving a response rate of 92% (47/51). The 5-year local control rate for all 51 patients was 38.0% and the median local control time was 25.5 months (95% confidence interval 14.6-36.3).Conclusion: The results suggest that proton-beam therapy is an effective treatment for patients with locally advanced esophageal cancer. Further studies are required to determine the optimal total dose, fractionation schedules, and best combination of proton therapy with chemotherapy.