Radiation therapy for loco-regionally recurrent esophageal cancer after surgery
Radiation therapy for loco-regionally recurrent esophageal cancer after surgery
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DOI：
10.1016/s0167-8140(01)00392-9
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发表时间：
2001-11-01
影响因子：
5.7
通讯作者：
Hosoi, Y
中科院分区：
文献类型：
--
作者：
Nemoto, K;Ariga, H;Hosoi, Y
目的：评价33例食管癌局部复发患者的放射治疗效果。方法：1988~1997年间，33例食管癌根治术后局部复发患者接受放射治疗，平均总剂量为61Gy。复发部位为锁骨上区14例，纵隔13例，锁骨上纵隔同时复发6例。如果患者有乙醚远处转移或恶性胸腔积液，他们将被排除在分析之外。接受预防性术后放疗的患者也被排除在分析之外。结果：中位生存期为7个月。1、2、3年生存率分别为33%、15%、12%。单因素分析显示，手术至复发时间短(P=0.0098)和锁骨上及纵隔同时复发(P=0.036)的患者预后较差。在多因素分析中，手术至复发的时间间隔(P<；0.001)和a-e(年轻患者预后较差，P=0.019)是有意义的预后因素。完全缓解9例(27%)，部分缓解21例(%)。11例患者可评价吞咽困难、胸痛、腰背痛等临床症状的变化，8例(73%)患者症状得到改善。结论：食管癌术后局部复发接受放射治疗的患者预后较差。然而，在这类患者中，有相当一部分患者症状缓解，一些患者有可能长期存活。(C)2001爱思唯尔爱尔兰科学有限公司。保留所有权利。
Purpose: To evaluate the treatment outcome of radiation therapy for 33 loco-regionally recurrent esophageal cancer patients.Methods: Between 1988 and 1997, 33 patients with loco-regional recurrence of esophageal cancer after curative surgery received radiation therapy at an average total dose of 61 Gy. The site of recurrence was the supraclavicular region in 14 patients, the mediastinal region in 13 patients, and both the supraclavicular and mediastinal regions in six patients. If patients had ether distant metastasis or malignant pleural effusion, they were excluded from analysis. Patients who received prophylactic postoperative irradiation were also excluded from analysis.Results: The median survival period was 7 months. The survival rates at 1, 2, and 3 years were 33, 15, and 12%, respectively. In univariate, analysis, patients with a short time interval between surgery and recurrence (P = 0.0098) and patients with recurrence in both the supraclavicular and mediastinal regions (P = 0.036) had a worse prognosis. In multivariate analysis, the time interval between surgery and recurrence (P < 0.001) and a-e (worse prognosis in younger patients, P = 0.019) were the significant prognostic factors. Complete or partial responses were observed in nine (27%) and 21 (64%) of the patients, respectively. Changes in clinical symptoms, such as dysphagia, chest pain and back pain, could be evaluated in 11 patients, and improvement in symptoms was obtained in eight (73%) patients.Conclusions: The prognosis of patients who received radiation therapy for postoperative loco-regional recurrence of esophageal cancer is poor. However, there is symptomatic relief in a significant proportion of such patients, and long-term survival is possible in some patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.