Long-term results of neoadjuvant chemoradiotherapy using cisplatin and 5-fluorouracil followed by esophagectomy for resectable, locally advanced esophageal squamous cell carcinoma.
Long-term results of neoadjuvant chemoradiotherapy using cisplatin and 5-fluorouracil followed by esophagectomy for resectable, locally advanced esophageal squamous cell carcinoma.
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DOI：
10.1093/jrr/rry047
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发表时间：
2018-09-01
影响因子：
2
通讯作者：
Nagata Y
中科院分区：
文献类型：
--
作者：
Murakami Y;Hamai Y;Emi M;Hihara J;Imano N;Takeuchi Y;Takahashi I;Nishibuchi I;Kimura T;Okada M;Nagata Y
本研究对可切除的局部晚期食管鳞状细胞癌(ESCC)患者行新辅助放化疗(NCRT)后行食道切除术的远期疗效进行了回顾性研究。总共分析了2008至2012年间收治的49名患者。化疗方案包括5-氟尿嘧啶和顺铂。原发灶、转移性淋巴结和择期结节的放射治疗剂量为40Gy20次/次。随后，行经胸食道切除加广泛淋巴清扫术。幸存者的中位随访期为86(55-111)个月。NCRT病理完全缓解17例(35%)。5年总生存率和无复发生存率分别为56%[95%可信区间：43~71%]和55%(95%可信区间：41~69%)。5年区域控制率为84%(95%可信区间：74~95%)。多变量分析显示，体重指数、N因子和%ΔSUVmax是影响总存活率的重要因素。复发16例(31%)，照射野内失败4例(8%)。NCRT的毒性一般较轻。术后并发症发生率为14%，其中V级1例(2%)。3级以上远期并发症5年发生率为22%(95%可信区间：7~36%)。异时性恶性肿瘤5年累积发病率为13%(95%可信区间：1~26%)。对于可切除的局部晚期ESCC患者，行NCRT和食道切除术的患者显示良好的局部控制性和总体存活率，术后并发症可接受。需要对晚期并发症和异时性恶性肿瘤进行长期仔细的随访。
This study retrospectively evaluated the long-term results of neoadjuvant chemoradiotherapy (NCRT) followed by esophagectomy for the patients with resectable, locally advanced esophageal squamous cell carcinoma (ESCC). Altogether, 49 patients treated from 2008 to 2012 were analyzed. Chemotherapy consisted of 5-fluorouracil and cisplatin. Radiotherapy was performed with a total dose of 40 Gy in 20 fractions for primary tumor, metastatic lymph nodes, and elective nodal area. Subsequently, transthoracic esophagectomy with extensive lymphadenectomy was performed. The median follow-up time for the survivors was 86 (range, 55–111) months. Pathological complete response from NCRT was observed in 17 (35%) patients. The 5-year overall survival and relapse-free survival rates were 56% [95% confidence interval (CI): 43–71%] and 55% (95% CI: 41–69%), respectively. The 5-year locoregional control rate was 84% (95% CI: 74–95%). Multivariate analyses revealed body mass index, N-factor, and %ΔSUVmax as significant factors for overall survival. Recurrences and within–irradiation field failure were observed in 16 (31%) and 4 (8%) patients, respectively. Toxicities of NCRT were generally mild. Postoperative Grade IIIb or worse complications were seen in 14% of patients, including one Grade V case (2%). The 5-year incidence rate of late complications of Grade 3 or worse was 22% (95% CI: 7–36%). The cumulative 5-year incidence rate of metachronous malignancies was 13% (95% CI: 1–26%). NCRT followed by esophagectomy for patients with resectable, locally advanced ESCC showed favorable locoregional control and overall survival, with acceptable postoperative complications. Long-term careful follow-up for late complications and metachronous malignancies is needed.
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影响因子：
15.3
作者：
Hamilton, Emma;Vohra, Ravinder S.;Griffiths, Ewen A.
通讯作者：
Griffiths, Ewen A.
影响因子：
51.1
作者：
Gebski, Val;Burmeister, Bryan;Simes, John
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作者：
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通讯作者：
Pignon, Jean-Pierre
影响因子：
3.7
作者：
Bosch, Dirk J.;Muijs, Christina T.;Plukker, John Th M.
通讯作者：
Plukker, John Th M.