Salvage definitive chemo-radiotherapy for locally recurrent oesophageal carcinoma after primary surgery: Retrospective review
Salvage definitive chemo-radiotherapy for locally recurrent oesophageal carcinoma after primary surgery: Retrospective review
复制标题
DOI：
10.1111/j.1440-1673.2008.02023.x
复制
发表时间：
2008-12-01
影响因子：
1.6
通讯作者：
Thomas, J.
中科院分区：
文献类型：
--
作者：
Baxi, S. H.;Burmeister, B.;Thomas, J.
确定食管癌局部复发患者初次手术后接受挽救性确定性放化疗治疗的总生存率和胃肠道毒性。对亚历山德拉公主医院525例食管癌或食管胃癌切除术患者进行的回顾性分析确定了14例在疾病局部复发后接受挽救性确定性放疗或放化疗的患者。我们分析了患者和治疗特征，以确定中位总生存期作为主要终点。检查胃肠道毒性，以确定在胸内放疗野内照射胃时是否发生毒性增加。采用挽救性明确化疗-放疗进行根治性治疗的患者的中位总生存期为16个月，2年总生存期为21%。1例患者在治疗后5年以上临床缓解。年龄、60岁及淋巴结复发是预后良好的因素。治疗依从性为93%，仅1例患者无法完成预期时间表。14%的患者出现3级或4级胃肠道毒性。对于体力状态良好的食管癌初次手术后局部复发的患者，应考虑挽救性化疗-放疗。该方案是可耐受的，毒性低，中位生存期可接受。
To determine the overall survival and gastrointestinal toxicity for patients treated with salvage definitive chemoradiotherapy after primary surgery for locoregional relapse of oesophageal carcinoma. A retrospective review of 525 patients who had a resection for oesophageal or oesophagogastric carcinoma at Princess Alexandra Hospital identified 14 patients treated with salvage definitive radiotherapy or chemo-radiotherapy, following localized recurrence of their disease. We analysed the patient and treatment characteristics to determine the median overall survival as the primary end point. Gastrointestinal toxicity was examined to determine if increased toxicity occurred when the stomach was irradiated within the intrathoracic radiotherapy field. The median overall survival for patients treated with curative intent using salvage definitive chemo-radiotherapy was 16 months and the 2-year overall survival is 21%. One patient is in clinical remission more than 5 years after therapy. Age,60 years old and nodal recurrence were favourable prognostic factors. Treatment compliance was 93% with only one patient unable to complete the intended schedule. Fourteen per cent of patients experienced grade 3 or 4 gastrointestinal toxicity. Salvage definitive chemo-radiotherapy should be considered for good performance status patients with oesophageal carcinoma who have a locoregional relapse after primary surgery. The schedule is tolerable with low toxicity and an acceptable median survival.