Impact of Interval Between Neoadjuvant Chemoradiation and Surgery Upon Morbidity and Survival of Patients with Squamous Cell Carcinoma of Thoracic Esophagus
Impact of Interval Between Neoadjuvant Chemoradiation and Surgery Upon Morbidity and Survival of Patients with Squamous Cell Carcinoma of Thoracic Esophagus
复制标题
DOI：
10.21873/anticanres.12848
复制
发表时间：
2018-09-01
影响因子：
2
通讯作者：
Okada, Morihito
中科院分区：
文献类型：
--
作者：
Furukawa, Takaoki;Hamai, Yoichi;Okada, Morihito
背景/目的：本研究旨在确定新辅助放化疗(NCRT)和食道切除术之间的间隔时间对局部晚期食管鳞癌(ESCC)患者治疗结果的影响。患者和方法：我们分析了2003年9月至2015年9月期间连续134名患者的数据，这些患者被诊断为局部晚期胸段食管鳞癌，并在接受nCRT治疗后进行了食道切除术。根据nCRT术后8周是否行食道切除术，将患者分为A、B两组。结果：两组在年龄、性别、功能状态、合并症、肿瘤部位、临床分期、R0切除率和对nCRT的病理反应方面具有可比性。B组肺炎和呼吸衰竭的发生率明显高于B组(p=0.03，p=0.009)。两组无复发(RFS)和总生存率(OS)无显著差异。而B组中R0期(P=0.009.0 4)和Ⅲ、IV期(P=0.0 5)患者的RFS明显较差。结论：从R0切除患者的呼吸道并发症和RFS对R0切除患者的影响来看，食道切除术应在nCRT后8周内进行
Background/Aim: The present study aimed to determine the effects of intervals between neoadjuvant chemoradiotherapy (nCRT) and esophagectomy on therapeutic outcomes in patients with locally advanced esophageal squamous cell carcinoma (ESCC). Patients and Methods: We analyzed data from 134 consecutive patients who were diagnosed with locally advanced ESCC of the thoracic esophagus and were treated by nCRT followed by esophagectomy between September 2003 and September 2015. We assigned the patients to groups A and B according to whether they underwent esophagectomy 8 weeks after nCRT. Results: The two groups were comparable in terms of age, gender, performance status, comorbidities, tumor location, clinical stage, R0 resection rates and pathological responses to nCRT. The incidences of pneumonia and respiratory failure were significantly higher in group B (p=0.03, p=0.009, respectively). Recurrence free (RFS) and overall (OS) survival rates did not significantly differ between the two groups. However, RFS was significantly poorer among patients with R0 resection (p=0.04) and those of cStages III and IV (p=0.009) in group B. Conclusion: Esophagectomy should proceed within eight weeks after nCRT from the viewpoints of respiratory morbidity and impact of RFS on patients with R0 resection.