Clinical observation of improved late course accelerated hyperfractionated radiotherapy with concurrent chemotherapy for locally advanced esophageal squamous cell carcinom
10.3760/cma.j.issn.1673-422X.2012.08.022
- VernacularTitle:改良同步后程加速超分割放化疗治疗局部晚期食管鳞癌的临床观察
- Author:
Mingping SUN
;
Dongqing WANG
;
Baosheng LI
;
Hongfu SUN
;
Yumei WEI
;
Zhongtang WANG
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Radiotherapy;
Cisplatin;
Survival rate;
Adverse effects
- From:
Journal of International Oncology
2012;39(8):637-640
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the efficacy and the adverse effects of improved late course accelerated hyperfractionated radiotherapy (LCAHRT) combined with cisplatin-based chemotherapy for locally advanced esophageal squamous cell carcinoma (ESCC).Methods 68 Patients with pathologically confirmed ESCC were enrolled.Conventional fractionation was implemented to 40 Gy/20 fractions,followed by LCAHRT delivered 2 fractions of 1.4 Gy with an interval of 6-8 hours per day to 14 fractions,thus the total dose was 59.6 Gy.Two cycles of cisplatin-based chemotherapy were administered concurrently,followed by two more cycles.The short-term efficacy of treatment,overall survival for 1-,3-,5-year,and treatment-related toxicity were evaluated.Results All patients successfully completed LCAHRT and the overall response rate was 91.6％ (62/68).The overall survival rate of 1-,3-,and 5-year was 75.5％,46.5％,22.7％,respectively.The incidence of radiation esophagitis (grade 3 or greater) was 26.4％,and no patients developed grade 3 or worse radiation pneumonitis.The radiation-induced skin injury were most of grade 0 or 1.Grade 3 of leucopenia and neutropenia were observed in 29.4％ and 7.4％ of patients,respectively,and grade 4 were both in 2.9％.During long-term follow-up,no esophageal stenosis and severe pulmonary fibrosis was developed except for two cases(2.9％)of esophageal mediastinal fistula.Conclusion Late course accelerated hyperfractionated radiotherapy combined with chemotherapy yields promising long-term survival,with lower treatment-related toxicity for patients of locally advanced esophageal squamous cell carcinoma.
