Long-term results of chemoradiotherapy with elective nodal irradiation for resectable locally advanced esophageal cancer in three-dimensional planning system
Long-term results of chemoradiotherapy with elective nodal irradiation for resectable locally advanced esophageal cancer in three-dimensional planning system
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三维规划系统中选择性淋巴结照射放化疗治疗可切除局部晚期食管癌的长期结果
DOI：
10.1007/s10147-023-02290-5
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Nagata Y
中科院分区：
文献类型：
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作者：
Miyoshi S;Nishibuchi I;Murakami Y;Katsuta T;Imano N;Hirokawa J;Hamai Y;Emi M;Okada M;Nagata Y
我们使用三维（3D）计划系统评估了可切除的局部晚期食管鳞状细胞癌（LA-ESCC）的确定性放化疗（CRT）与选择性淋巴结照射（ENI）的长期结果。纳入了根据国际癌症控制联盟TNM分类（第八版）的I-IV期LA-ESCC患者。在IV期，仅包括锁骨上淋巴结（LN）转移。所有患者接受放射治疗与ENI和同步化疗与铂和5-氟尿嘧啶。ResultsThe中位年龄的患者为70岁（范围52-83岁）。分别在3例（5%）、28例（43%）、22例（34%）和12例（18%）患者中观察到I、II、III和IV期疾病。中位处方剂量为66戈伊（范围50.4-66戈伊）。存活者的中位随访期为71个月（范围8-175个月）。5年总生存率（OS）和无进展生存率分别为54%和43%。I-II期和III-IV期的5年OS率分别为67%和42%。29例患者（45%）发生复发，仅2例患者（3%）发生局部淋巴结复发。在8例患者（12%）中观察到3级或以上晚期不良事件。5级心力衰竭发生在两名患者（3%），都有心血管疾病treatment.ConclusionThe长期结果的明确CRT与ENI可切除的LA-ESCC是有利的。三维计划系统的ENI可以减少局部LN复发和晚期不良事件。
BackgroundWe evaluated the long-term results of definitive chemoradiotherapy (CRT) with elective nodal irradiation (ENI) using a three-dimensional (3D) planning system for resectable, locally advanced esophageal squamous cell carcinoma (LA-ESCC).MethodsThis retrospective study included 65 patients with LA-ESCC who started CRT between 2006 and 2017. Patients with Stage I–IV LA-ESCC according to the Union for International Cancer Control TNM classification (eighth edition) were included. In stage IV, only supraclavicular lymph node (LN) metastasis was included. All patients received radiotherapy with ENI and concurrent chemotherapy with platinum and 5-fluorouracil.ResultsThe median age of the patients was 70 years (range 52–83 years). Stage I, II, III, and IV diseases were observed in 3 (5%), 28 (43%), 22 (34%), and 12 patients (18%), respectively. The median prescription dose was 66 Gy (range 50.4–66 Gy). The median follow-up period for the survivors was 71 months (range 8–175 months). The 5-year overall survival (OS) and progression-free survival rates were 54 and 43%, respectively. The 5-year OS rates for stages I–II and III–IV were 67 and 42%, respectively. Recurrence occurred in 29 patients (45%), and recurrence of regional LNs only occurred in 2 patients (3%). Grade 3 or higher late adverse events were observed in 8 patients (12%). Grade 5 heart failure occurred in two patients (3%); both had cardiovascular disease before treatment.ConclusionThe long-term results of definitive CRT with ENI for resectable LA-ESCC were favorable. ENI with a 3D planning system may reduce regional LN recurrence and late adverse events.