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Study on Multimodality treatment for Locally Advanced Esophageal Cancer

局部晚期食管癌综合治疗研究

基本信息

批准号：
08671498
负责人：
FUHITA Hiromasa
金额：
$ 1.47万
依托单位：
Kurume University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1998
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-08671498/
关键词：
Esophageal cancer Locally advanced cancer (T4)Multimodality treatment daily low-dose CTx Prospective trial Induction chemoradiotherapy Informed consent Area under the curve (AUC)Prospective trial Area under the curve(AUC)局所進行癌放射線

项目摘要

Purpose :To determine the optimal multimodality treatment to improve survival in patients with a locally advanced esophageal cancerMaterial and Methods :The subject were 48 patients with a T4 esophageal cancer who underwent chemoradiotherapy (CRTx) with or without esophagectomy in Kurume University Hospital from 1994 to 1998. Based on informed consent, patients chose one arm among the following three arms of treatment.Arm-1 : Pre- and post-operative chemoradiotherapy (daily low-dosage CDDP/5Fu with hyperfraction radiotherapy, 6OGy)Arm-2 : Postoperative chemoradiotherapy (one-shot high-dosage CDDP/5Fu with sequential standard RTx, 5OGy)Arm-3 : Chemoradiotherapy alone (one-shot high-dosage CDDP/5Fu with concurrent standard RTx, 6OGy)Results :The patients' distribution was 26 in Arm-1, 16 in Arm-2, and 6 in Arm-3. The effective rates after CRTx were 88% (CR : 63%, PR : 25%) after two courses of daily low-dosage CTx with hyperfraction RTx, and 50% (CR : 17%, PR : 33%) after two courses of one-shot high-dosage CTx with standard RTx. The resectable rates were 54% (curative : 35%, palliative 19%) in Arm-1. and 81% (curative : 6%, palliative : 75%) in Arm-2. The 1-, 2-, and 3-year survival rates were 56%, 27%, and 27% in Arm-1, 41%, 21%, and 0% in Arm-2, and 21%, 21%, and 0% in Arm-3. In particular, these survival rates were 79%, 31%, and 31% for patients who underwent esophagectomy in Arm-1.Conclusion :Daily low-dosage CDDP/ 5Fu administration with hyperfraction radiotherapy was more effective for a locally advanced (T4) esophageal cancer than one-shot high-dosage CDDP and 5Fu administration with standard radiotherapy. Preoperative use of the daily low-dosage CTx + hyperfraction RTx increased the rate of curative resection in patients with a T4 esophageal cancer. Pre and post-operative uses of this combination can improve the survival of patients with such a cancer.

目的：确定最佳的多模式治疗，以提高生存率的局部晚期食管癌患者材料和方法：受试者是48例T4食管癌接受放化疗（CRTx）与或不食管切除术在库尔斯克大学医院从1994年至1998年。根据知情同意书，患者在以下三个治疗组中选择一个治疗组。（每日低剂量CDDP/5 Fu+超分割放疗，60 Gy）第2组：术后放化疗（一次性高剂量CDDP/5 Fu，序贯标准RTx，50 Gy）第3组：单纯放化疗（一次性高剂量CDDP/5 Fu，同时标准RTx，60 Gy）结果：患者分布为第1组26例，第2组16例，第3组6例。CRTx后有效率88%（CR：63%，PR：25%），高剂量CTx+标准RTx治疗2个疗程后有效率50%（CR：17%，PR：33%）。第1组的可切除率为54%（治愈性：35%，姑息性19%）。第2组为81%（治愈：6%，姑息：75%）。第1组的1年、2年和3年生存率分别为56%、27%和27%，第2组为41%、21%和0%，第3组为21%、21%和0%。结论：低剂量顺铂/5-Fu联合超分割放射治疗局部晚期（T4）食管癌的疗效优于高剂量顺铂/5-Fu联合常规放射治疗。术前每日使用低剂量CTx +超分割RTx可提高T4食管癌患者的治愈性切除率。术前和术后使用这种组合可以提高这种癌症患者的生存率。