Therapeutic results of proton beam therapy with concurrent chemotherapy for cT1 esophageal cancer and salvage endoscopic therapy for local recurrence
Therapeutic results of proton beam therapy with concurrent chemotherapy for cT1 esophageal cancer and salvage endoscopic therapy for local recurrence
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质子束治疗联合化疗治疗cT1食管癌及挽救性内镜治疗局部复发的疗效
DOI：
10.1007/s10388-020-00715-y
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发表时间：
2020
期刊：
影响因子：
2.4
通讯作者：
Yano Tomonori
中科院分区：
文献类型：
--
作者：
Sato Daiki;Motegi Atsushi;Kadota Tomohiro;Kojima Takashi;Bando Hideaki;Shinmura Kensuke;Hori Keisuke;Yoda Yusuke;Oono Yasuhiro;Zenda Sadamoto;Ikematsu Hiroaki;Akimoto Tetsuo;Yano Tomonori
背景质子束治疗（PBT）联合化疗治疗食管鳞状细胞癌（ESCC）是一种有前景的治疗方法.本研究的目的是评价同步化学质子治疗（CCPT）的结果，即，PBT与cT 1 ESCC的同步化疗和局部复发的挽救性内镜治疗MethodsPatients with clinical T1 ESCC who encountered CCPT（60 GyE）between April 2013 and April 2017 at National Cancer Center Hospital East were investigated.通过内窥镜检查评价CCPT在原发部位的疗效;原发完全缓解（CR）定义为肿瘤病变/溃疡消失和活检时无癌细胞。内镜下评价与常规放化疗相同的协议。CCPT后局部复发的治疗与内镜下切除术cT 1a和食管切除术或光动力疗法cT 1b+。ResultsOf 44例（中位年龄，70岁），接受CCPT，43例（98%）达到原发性CR。44例患者中，3年总生存率为95.2%。5例（11%）患者出现局部复发，无区域淋巴结或远处转移，并接受了内镜切除或光动力治疗。所有5例患者均存活，平均23 months.ConclusionsThe结果表明，CCPT是一种有效的治疗cT 1食管鳞癌和仔细的内镜随访，可以更好地局部控制与挽救内镜治疗。
BackgroundProton beam therapy (PBT) with concurrent chemotherapy is promising for esophageal squamous cell carcinoma (ESCC). The aim of study was to evaluate the outcome of concurrent chemo-proton therapy (CCPT), i.e., PBT with concurrent chemotherapy for cT1 ESCC and the salvage endoscopic therapy for local recurrence.MethodsPatients with clinical T1 ESCC who underwent CCPT (60 GyE) between April 2013 and April 2017 at the National Cancer Center Hospital East were investigated. The efficacy of CCPT at the primary site was evaluated via endoscopy; primary complete response (CR) was defined as disappearance of the tumor lesion/ulcer and absence of cancer cells on biopsy. Endoscopic evaluation was performed with the same protocol of conventional chemoradiotherapy. Local recurrence after CCPT was treated with endoscopic resection for cT1a and with esophagectomy or photodynamic therapy for cT1b+.ResultsOf the 44 patients (median age, 70 years) that underwent CCPT, 43 patients (98%) achieved primary CR. Among the 44 patients, the 3-year overall survival rate was 95.2%. Five patients (11%) developed local recurrence without regional lymph node or distant metastasis and received endoscopic resection or photodynamic therapy. All five patients were alive with no recurrence after a median 23 months.ConclusionsThe results suggest that CCPT is an effective treatment for cT1 ESCC and careful endoscopic follow-up allows preferable local control with salvage endoscopic treatment.