Treatment Results of Esophageal Cancer by Different Treatment Modalities

以不同方式治療食道癌之成果報告

許智捷(Chih-Chiech Hsu) ； 林秋燕(Chiu-Yen Lin) ； 林玲綿(Ling-Mian Lin) ； 劉建鴻(Chien-Hong Liu) ； 張東浩(Tung-Hao Chang)

《中華放射線醫學雜誌》 30卷3期 (2005/06) Pp. 147-152

摘要

Esophageal cancer is a malignant gastro-intestinal cancer with lower curable chance. The combined modalities of treatment such as concurrent chemoir-radiation (CCRT) or adjuvant radiotherapy after operation (OP+R/T) was recommended recently. In this study, the treatment outcome of patients with different stages of esophageal cancer that were treated by different methods was analyzed. These data will help establishing a treatment plan on the basis of scientific evidence.
From January 2000 until December 2002, 71 patents had biopsy proven carcinoma of the esophagus (all were squamous cell carcinoma), received primary definite treatment in our hospital. Thirteen patients received radiotherapy (R/T) alone, 37 patients received CCRT, and 21 patients underwent surgery followed by adjuvant radiotherapy (OP+R/T). The survival rate and local control rate were analyzed by Kaplan-Meier method and log-rank test to determine the difference of treatment outcome between groups. Cox regression method was used for multivariate analysis of different independent factors, which might influence survival rate and local control rate.
The 2-year survival rates of stage Ⅱ, Ⅲ, and Ⅳ diseases were 37.5%, 28.2% and 0%, respectively (log-rank test p＜0.001). The 2-year survival rates of R/T, CCRT, and OP+R/T groups in stage Ⅱ and Ⅲ patients were 0%, 35.4%, and 39.1%, respectively (log-rank test p=0.16). The multivariate analysis did not show any significant factors when calculated stages and different treatment groups. Only the status of local control influenced survival rate significantly (Cox regression p=0.001). The 2-year local control rates of R/T, CCRT, and OP+R/T were 0%, 36.7% and 67.0%, respectively (log-rank test p＜0.001). There was an interesting finding that increasing dose of radiotherapy more than 60 Gy led to decrease the survival in CCRT group. The patients who were treated by radiotherapy less than 60 Gy had higher 2-year survival rate of 71.4% than those treated with more than 60 Gy radiation (2-year survival rate: 10%) (log-rank test p=0.004).
CCRT and OP+R/T for the treatment of esophageal cancer would achieve better survival rate and local control than R/T alone.

關鍵字

合併化學及放射治療 ； 食道腫瘤 ； 食道，手術治療 ； 食道，放射治療

並列摘要

Esophageal cancer is a malignant gastro-intestinal cancer with lower curable chance. The combined modalities of treatment such as concurrent chemoir-radiation (CCRT) or adjuvant radiotherapy after operation (OP+R/T) was recommended recently. In this study, the treatment outcome of patients with different stages of esophageal cancer that were treated by different methods was analyzed. These data will help establishing a treatment plan on the basis of scientific evidence.
From January 2000 until December 2002, 71 patents had biopsy proven carcinoma of the esophagus (all were squamous cell carcinoma), received primary definite treatment in our hospital. Thirteen patients received radiotherapy (R/T) alone, 37 patients received CCRT, and 21 patients underwent surgery followed by adjuvant radiotherapy (OP+R/T). The survival rate and local control rate were analyzed by Kaplan-Meier method and log-rank test to determine the difference of treatment outcome between groups. Cox regression method was used for multivariate analysis of different independent factors, which might influence survival rate and local control rate.
The 2-year survival rates of stage Ⅱ, Ⅲ, and Ⅳ diseases were 37.5%, 28.2% and 0%, respectively (log-rank test p＜0.001). The 2-year survival rates of R/T, CCRT, and OP+R/T groups in stage Ⅱ and Ⅲ patients were 0%, 35.4%, and 39.1%, respectively (log-rank test p=0.16). The multivariate analysis did not show any significant factors when calculated stages and different treatment groups. Only the status of local control influenced survival rate significantly (Cox regression p=0.001). The 2-year local control rates of R/T, CCRT, and OP+R/T were 0%, 36.7% and 67.0%, respectively (log-rank test p＜0.001). There was an interesting finding that increasing dose of radiotherapy more than 60 Gy led to decrease the survival in CCRT group. The patients who were treated by radiotherapy less than 60 Gy had higher 2-year survival rate of 71.4% than those treated with more than 60 Gy radiation (2-year survival rate: 10%) (log-rank test p=0.004).
CCRT and OP+R/T for the treatment of esophageal cancer would achieve better survival rate and local control than R/T alone.

並列關鍵字

Combined radiotherapy/Chemotherapy ； Esophageal neoplasm ； Esophageal, surgery ； Esophagus, therapeutic radiology