Comparison of Chemoradiotherapy with Radiotherapy Alone in Patients with Esophageal Adenocarcinoma
Comparison of Chemoradiotherapy with Radiotherapy Alone in Patients with Esophageal Adenocarcinoma
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DOI：
10.1269/jrr.10166
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发表时间：
2011-05-01
影响因子：
2
通讯作者：
Nakano, Takashi
中科院分区：
文献类型：
--
作者：
Shirai, Katsuyuki;Tamaki, Yoshio;Nakano, Takashi
尽管确定性放化疗（CRT）广泛用于局部晚期食管腺癌，但很少有证据表明CRT与单纯放疗（RT）相比可改善食管腺癌患者的生存率。因此，我们回顾性评价了食管腺癌患者接受CRT和单纯RT治疗的结局。患者在群马县癌症中心（日本大田）和群马大学医院（日本前桥）接受治疗。患者在治疗前提供书面知情同意书。排除有远处转移的患者。自2002年以来，当患者有足够的骨髓、肝脏和肾脏功能时，已经进行了由RT、奈达铂和5-氟尿嘧啶组成的CRT。1993年11月至2006年4月，8例患者接受CRT治疗，12例仅接受RT治疗。存活患者的中位随访期为19个月。CRT组的完全缓解率明显高于单纯RT组（87%比33%，P = 0.05）。全组患者2年总生存率为41%，中位生存时间为18个月。接受CRT治疗的患者的2年总生存率为58%，明显优于单纯RT的24%（P = 0.02）。与单纯放疗相比，CRT可改善食管腺癌患者的预后。
Despite the wide use of definitive chemoradiotherapy (CRT) for locally advanced esophageal adenocarcinoma, there is little evidence that CRT improves the survival of patients with esophageal adenocarcinoma compared with radiotherapy (RT) alone. Therefore, we retrospectively evaluated the outcome of patients with esophageal adenocarcinoma treated by CRT and RT alone. Patients were treated at the Gunma Prefectural Cancer Center (Ota, Japan) and the Gunma University Hospital (Maebashi, Japan). Patients provided written informed consent before treatment. Patients with distant metastases were excluded. CRT consisting of RT, nedaplatin, and 5-fluorouracil has been performed since 2002 when patients have adequate bone marrow, liver, and renal function. Between November 1993 and April 2006, 8 patients were treated by CRT and 12 were RT alone. The median follow-up period of surviving patients was 19 months. CRT group had a significantly higher complete response rate than those RT alone group (87% vs. 33%, P = 0.05). Of all patients, 2-year overall survival rate was 41% and the median survival time was 18 months. The 2-year overall survival of patients treated by CRT was 58%, significantly better than 24% of those with RT alone (P = 0.02). CRT can improve outcomes of patients with esophageal adenocarcinoma compared with RT alone.