The value of the planned neoadjuvant radiotherapy or chemoradiotherapy for the non?radical resection of esophageal squamous cell carcinoma
10.3760／cma.j.issn.0253?3766.2019.04.010
- VernacularTitle:不可根治性切除食管癌的计划性新辅助放疗及放化疗的疗效
- Author:
Wenjie NI
1
;
Wei DENG
;
Zefen XIAO
;
Zongmei ZHOU
;
Xin WANG
;
Dongfu CHEN
;
Qinfu FENG
;
Jun LIANG
;
Jima LYU
;
Nan BI
;
Lei DENG
;
Tao ZHANG
;
Wenqing WANG
;
Qi XUE
;
Shugeng GAO
;
Juwei MU
;
Yousheng MAO
;
Dali WANG
;
Jun ZHAO
;
Yushun GAO
;
Jinfeng HUANG
;
Fengwei TAN
;
Liang ZHAO
;
Fang LYU
;
Guochao ZHANG
Author Information
1. 国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院放疗科100021
- Keywords:
[Subject words] Esophageal neoplasms;
Radiotherapy;
Concurrent chemoradiotherapy;
Prognosis
- From:
Chinese Journal of Oncology
2019;41(4):295-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective The role of planned neoadjuvant radiotherapy or chemoradiotherapy in the non?radical resection of esophageal squamous cell carcinoma was unclear. The study aimed to evaluate their therapeutic effect and analyze the prognostic factors. Methods We retrospectively analyzed the clinical data of locally advanced esophageal squamous cell carcinoma who received neoadjuvant radio therapy ( 33 patients) and concurrent chemoradiotherapy (119 patients) from January 2004 to December 2016 in our single?institution database.The survival rates were calculated by Kaplan?Meier method. The prognostic factors were analyzed by using Log rank test and Cox proportional hazards model. Results The median follow?up was 29.8 months. One hundred and one patients survived more than 3 years. The rates of overall survival (OS) and disease?free survival ( DFS) at 3 years were 63.9% and 55.6%, respectively.The rates of complete, partial and minimal pathological response of the primary tumor were 50.3%, 38.4%, 11.3%, the corresponding 3?year OS were 75.5%, 57.4%, 27.3%( P＜0.001) and 3?year DFS were 72.0%, 44.7%, 17.6%(P＜0.001), respectively.The postoperative lymph node metastasis rate was 27.0%. The 3?year OS and DFS of the lymph node positive group was 45.6% and 32.8%, significantly lower than 70.8% and 63.7%of the negative group (both P＜0.001).The 3?year OS and DFS of pathologic stage Ⅰ,Ⅱ,ⅢA,ⅢB andⅥ A were 76.2%, 57.4%, 64.7%, 35.0%, 33.3%( P＜0.001) and 70.1%, 49.3%, 41.2%, 22.1%, 33.3%(P＜0.001), respectively.The operation?related mortality was 3.3%. Multivariate analysis showed that chest pain, postoperative respiratory failure, pathological differentiation, more than 15 lymph node dissection and ypTNM stage were the independent prognostic factors of OS ( P＜0.05 for all). Conclusions The planned neoadjuvant radiotherapy or chemoradiotherapy for the non?radical resection of advanced esophageal squamous cell carcinoma could result in favorable survival. The chest pain, postoperative respiratory failure, pathological differentiation, the number of lymph node resection and ypTNM stage are the independent prognostic factors of the prognosis of these patients.
