PROPOSAL FOR STANDARD RADIOTHERAPY METHODS FOR SUPERFICIAL ESOPHAGEAL CANCER: A MULTICENTER RETROSPECTIVE EVALUATION
PROPOSAL FOR STANDARD RADIOTHERAPY METHODS FOR SUPERFICIAL ESOPHAGEAL CANCER: A MULTICENTER RETROSPECTIVE EVALUATION
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表浅食管癌标准放射治疗方法的提案：多中心回顾性评估
DOI：
10.11182/jastro1989.12.169
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
T. Okawa
中科院分区：
文献类型：
--
作者：
S. Yamada;K. Nemoto;Y. Takai;Y. Hirokawa;M. Hareyama;H. Nagakura;Y. Nishimura;N. Hayabuchi;M. Oguchi;Yoshiyuki Ito;K. Sakai;T. Okawa
对JASTRO研究组多中心放射治疗的238例食管鳞状细胞癌患者进行回顾性分析。 115 名患者仅接受外部放射治疗 (ERT)，70 名患者接受 ERT 和高剂量率腔内放射治疗 (HDR)，53 名患者接受 ERT 和低剂量率腔内放射治疗 (LDR)。在大多数患者中，ERT 的视野大小由原发肿瘤定义，有时使用内窥镜检查用夹子标记其边缘。单纯ERT组5年总生存率和5年局部控制率分别为71%、46%，HDR组51%、42%，LDR组73%、43%。在所有组中，总剂量水平的局部控制率没有显着差异。经超声检查深度确诊的55例粘膜肿瘤5年局部控制率为70%，101例粘膜下肿瘤5年局部控制率为65%。单独ERT组和LDR组的并发症较轻，但对于接受HDR治疗的分数大小为5 Gy或以上的患者，有时会致命。与ICRT组的照射总剂量相比，并发症发生率与腔内放射治疗（ICRT）分次大小的相关性更大。 LDR组虽然局部控制率最差，但5年后观察到该组有5次复发。三组间转移发生率无显着差异。患者不是死于原发性食管癌，而是死于其他原因。从局部控制率及并发症情况分析，以下浅表性食管癌的治疗方法被认为是合理和可允许的，即单独ERT组ERT总剂量为60～70Gy，分30～35次；ERT总剂量为25次，总剂量50Gy；HDR-ICRT组，总剂量为4次16Gy；或30次总剂量为60Gy。 HDR 组的 ERT 剂量为 8 Gy，分 2 次 HDR-ICRT 剂量；LDR 组的 ERT 总剂量为 30 次剂量 60 Gy，然后 LDR-ICRT 分 4 次 16 Gy。虽然 HDR-ICRT 中通常使用每周两次 4 Gy 的分割尺寸，但 HDR-ICRT 也可以选择每周使用 5 次 2 Gy 的分割尺寸。通过回顾性分析，我们推荐了浅表性食管癌的放射治疗方法。为了获得最终的最佳治疗方法，还需要进一步的前瞻性研究。
Two hundred and thirty eight patients with squamous cell carcinoma of the esophagus treated with irradiation in the multicenter of a research group of JASTRO were analyzed retrospectively. One hundred and fifteen patients were treated with external radiation therapy (ERT) alone, 70 with ERT and high dose rate intracavitary radiation therapy (HDR), and 53 with ERT and low dose rate intracavitary radiation therapy (LDR). In most patients the field size of ERT was defined by primary tumor the margin of which was sometimes marked with clips using endoscopy. Five-year overall survival rate and 5-year local control rate were 71%, 46% in ERT alone group, 51%, 42% in HDR group, and 73%, 43% in LDR group, respectively. In all groups there was no significant difference in the local control rate by total dose levels. Five-year local control rate of 55 mucosal tumors the depth of which was confirmed by echogram was 70%, and that of 101 submucosal tumors was 65%. Complications of ERT alone group and LDR group were mild, but sometimes fatal in patients treated with a fraction size of 5 Gy or more by HDR. The complication rate was more correlated with the fraction size of intracavitary radiation therapy (ICRT) than the total dose of irradiation in ICRT group. Although the local control rate of LDR group was worst, five recurrences of the group were observed after five years later. There was no significant difference in the incidence of metastasis among the three groups. Patients died rather from the other reasons than from their primary esophageal cancers. From the analysis of local control rate and complications, the following treatment methods for superficial esophageal cancer are considered to be reasonable and permissible, that is, a total dose of 60 to 70 Gy in 30 to 35 fractions by ERT for ERT alone group, a total dose of 50 Gy in 25 fractions by ERT followed by 16 Gy in 4 fractions by HDR-ICRT or a total dose of 60 Gy in 30 fractions by ERT followed by 8 Gy in 2 fractions by HDR-ICRT for HDR group, and a total dose of 60 Gy in 30 fractions by ERT followed by 16 Gy in 4 fractions by LDR-ICRT for LDR group. Although fraction size of 4 Gy by twice a week is usually used in HDR-ICRT, fraction size of 2 Gy by five times a week is employed as an option of HDR-ICRT. We recommended aradiation treatment method for superficial esophageal cancer from a retrospective analysis. To obtain a final optimal treatment method, a further prospective study is needed.
影响因子：
158.5
作者：
HERSKOVIC, A;MARTZ, K;EMAMI, B
通讯作者：
EMAMI, B