- 期刊
Treatment Results of Esophageal Cancer after Radiotherapy Alone or Concurrent Chemoradiothepapy
食道癌以單獨放射治療或合併同步放射化學治療結果
摘要
Purpose: To analyze the treatment results of the patients with esophageal cancer after radiotherapy (RT) alone or concurrent chemoradiotherapy (CCRT) and identify possible prognostic factors. Methods and Materials: Between February 1997 and February 2007, we treated 118 patients who had previously untreated esophageal carcinoma using definitive RT alone or CCRT. Fifty-two patients (44.1%) underwent RT alone and 66 patients (55.9%) underwent CCRT. Radiotherapy was delivered with conventional technique in 58 patients, three-dimensional conformal radiation therapy (3DCRT) in 56 patients, and intensity-modulated radiation therapy (IMAT) in 4 patients. The median dose of RT was 59.4 Gy. Survival rates were calculated from the end of the radiotherapy with the Kaplan-Meier method. Results: The median follow-up was 4 months for all patients and 25 months for those alive. Ten patients were alive, 102 patients died, and 6 patients were lost to follow-up. The 4-year overall survival of all patients were 8.2%. The 4-year overall survival of the patients in the RT alone and the CORT arm was 2.7% and 13.8%, respectively (p=0.188). The 4-year overall survival rate of stage Ⅱ, Ⅲ, and Ⅳ Was 9%, 14.6%, and 0%, respectively (p=0.045). There is no survival benefit for patient treated with 3DCRT or IMRT compared with conventional technique. A higher pretreatment hemoglobin (10 gm/dl or more) resulted in a better survival (p=0.001). In multivariate analysis, stage, CCRT, pretreatment hemoglobin, and completion of RT course were significant predictors of survival (p=0.033, 0.046, 0.032, ＜0.001, respectively). Adding chemotherapy to radiotherapy did not increase treatment mortality and morbidity. Three-dimensional conformal radiation therapy (3DCRT)/IMRT decreased incidence of radiation pneumonitis compared with conventional technique (p=0.011). Conclusions: There is a trend for a better survival in the CCRT group and adding chemotherapy did not bring more toxicities. Higher pretreatment hemoglobin, early stage, CCRT, completion of AT course were significant predictors of better survival. New AT technique with 3DCRT/IMRT did not offer survival benefit, but decreased incidence of radiation pneumonitis.
並列摘要
Purpose: To analyze the treatment results of the patients with esophageal cancer after radiotherapy (RT) alone or concurrent chemoradiotherapy (CCRT) and identify possible prognostic factors. Methods and Materials: Between February 1997 and February 2007, we treated 118 patients who had previously untreated esophageal carcinoma using definitive RT alone or CCRT. Fifty-two patients (44.1%) underwent RT alone and 66 patients (55.9%) underwent CCRT. Radiotherapy was delivered with conventional technique in 58 patients, three-dimensional conformal radiation therapy (3DCRT) in 56 patients, and intensity-modulated radiation therapy (IMAT) in 4 patients. The median dose of RT was 59.4 Gy. Survival rates were calculated from the end of the radiotherapy with the Kaplan-Meier method. Results: The median follow-up was 4 months for all patients and 25 months for those alive. Ten patients were alive, 102 patients died, and 6 patients were lost to follow-up. The 4-year overall survival of all patients were 8.2%. The 4-year overall survival of the patients in the RT alone and the CORT arm was 2.7% and 13.8%, respectively (p=0.188). The 4-year overall survival rate of stage Ⅱ, Ⅲ, and Ⅳ Was 9%, 14.6%, and 0%, respectively (p=0.045). There is no survival benefit for patient treated with 3DCRT or IMRT compared with conventional technique. A higher pretreatment hemoglobin (10 gm/dl or more) resulted in a better survival (p=0.001). In multivariate analysis, stage, CCRT, pretreatment hemoglobin, and completion of RT course were significant predictors of survival (p=0.033, 0.046, 0.032, ＜0.001, respectively). Adding chemotherapy to radiotherapy did not increase treatment mortality and morbidity. Three-dimensional conformal radiation therapy (3DCRT)/IMRT decreased incidence of radiation pneumonitis compared with conventional technique (p=0.011). Conclusions: There is a trend for a better survival in the CCRT group and adding chemotherapy did not bring more toxicities. Higher pretreatment hemoglobin, early stage, CCRT, completion of AT course were significant predictors of better survival. New AT technique with 3DCRT/IMRT did not offer survival benefit, but decreased incidence of radiation pneumonitis.
延伸閱讀
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