Details of recurrence sites after elective nodal irradiation (ENI) using 3D-conformal radiotherapy (3D-CRT) combined with chemotherapy for thoracic esophageal squamous cell carcinoma

DOI：

10.1016/j.radonc.2010.10.021

发表时间：

2011-02-01

期刊：

RADIOTHERAPY AND ONCOLOGY

影响因子：

5.7

通讯作者：

中科院分区：

医学1区

文献类型：

作者：

Yamashita, Hideomi;Okuma, Kae;Nakagawa, Keiichi

目的：描述选择性淋巴结照射（ENI）在胸部食管鳞状细胞癌（SqCC）的最终放化疗（CRT）中使用3d适形放疗的复发模式。方法与材料：从我们的数据库中招募了2000年6月至2009年7月新诊断的I-IVB期胸段食管SqCC患者126例，并在我所进行了3D-CRT治疗。最终CRT包括奈达铂/5FU两个周期，每4周重复一次，同时放射治疗50-50.4 Gy，分25-28次进行。放疗完成前，除肿瘤总体积外，将N1和M1a淋巴结作为ENI进行放疗。结果：126例患者均纳入分析，肿瘤分期如下：T1/T2/T3/T4, 28/18/54/26；N0和N1, 50/76;mo / M1a /数M1b 91/5/30。63例存活患者的平均随访时间为28.3（±22.8）个月。87例患者（69%）在完成CRT治疗后至少一次无肿瘤残留，达到完全缓解（CR）。达到CR后，40例患者均出现局部和远处淋巴结衰竭（局部20例，远处20例），无其他部位复发的患者出现选择性淋巴结衰竭。上胸段食管癌的局部复发率（34%）明显高于中胸段（9%）或下胸段（11%）。2年和3年的总生存率分别为56%和43%。1年、2年和3年无病生存率分别为46%、38%和33%。结论：在食管SqCC的CRT治疗中，ENI可有效预防局部淋巴结衰竭。上胸段食管癌的局部复发率明显高于中、下胸段食管癌。2010爱思唯尔爱尔兰有限公司版权所有。放射治疗和肿瘤学98 (2011)255-260

Purpose: To describe patterns of recurrence of elective nodal irradiation (ENI) in definitive chemoradiotherapy (CRT) for thoracic esophageal squamous cell carcinoma (SqCC) using 3D-conformal radiotherapy.Methods and materials: One hundred and twenty-six consecutive patients with stages I-IVB thoracic esophageal SqCC newly diagnosed between June 2000 and July 2009 and treated with 3D-CRT in our institution were recruited from our database. Definitive CRT consisted of two cycles of nedaplatin/5FU repeated every 4 weeks, with concurrent radiation therapy of 50-50.4 Gy in 25-28 fractions. Until completion, radiotherapy was delivered to the N1 and M1a lymph nodes as ENI in addition to gross tumor volume.Results: All 126 patients were included in this analysis, and their tumors were staged as follows: T1/T2/T3/T4, 28/18/54/26; N0/N1, 50/76; M0/M1a/M1b, 91/5/30. The mean follow-up period for the 63 surviving patients was 28.3 (+/- 22.8) months. Eighty-seven patients (69%) achieved complete response (CR) with-out any residual tumor at least once after completion of CRT. After achieving CR, each of 40 patients experienced failures (local = 20 and distant = 20) and no patient experienced elective nodal failure without having any other site of recurrence. The upper thoracic esophageal carcinoma showed significantly more (34%) relapses at the local site than the middle (9%) or lower thoracic (11%) carcinomas. The 2-year and 3-year overall survival was 56% and 43%, respectively. The 1-year, 2-year and 3-year disease-free survival was 46%, 38% and 33%, respectively.Conclusions: In CRT for esophageal SqCC, ENI was effective for preventing regional nodal failure. The upper thoracic esophageal carcinomas had significantly more local recurrences than the middle or lower thoracic sites. (C) 2010 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 98 (2011) 255-260

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

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