Involved field irradiation(IFI)versus elective nodal irradiation(ENI)in combination with concurrent chemotherapy for esophageal thoracic squamous cell cancer:a prospective,randomized, multicenter,controlled study
10.3760/cma.j.issn.1004-4221.2018.03.004
- VernacularTitle:胸段食管鳞癌根治性放化疗IFI和ENI前瞻性多中心随机对照临床研究
- Author:
Jiahua LYU
1
;
Abulimiti·Yisikandaer
;
Tao LI
;
Xiaozhi ZHANG
;
Zhongge TIAN
;
Xiaohu WANG
;
Long CHEN
;
Bing LU
;
Hong CHEN
;
Jie YANG
;
Qifeng WANG
;
Jinrong ZHANG
;
Youguo MA
;
Rui LIU
;
Ruifeng LIU
;
Hare AYIGULI·
;
Jinyi LANG
Author Information
1. 610041成都,四川省肿瘤医院,电子科技大学医学院附属肿瘤医院放疗中心
- Keywords:
Esophageal neoplasms/radiotherapy;
Elective nodal irradiation;
Involved field irradiation;
Toxicities;
Patterns of failure
- From:
Chinese Journal of Radiation Oncology
2018;27(3):245-249
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study was conducted to evaluate treatment-related toxicities,the patterns of failure,overall survival(OS)and progression-free survival(PFS)by comparing IFI with ENI in combination with chemotherapy. Methods Eligible patients were treated with concurrent chemoradiotherapy and randomized into either an IFI or ENI arm. The primary end points wereacute treatment-related toxicities. The secondary end points were patterns of failure,OS and PFS. Kaplan?Meier survival rate of the method for calculating the Logrank test difference method. Results Between April 2012 and October 2016,a total of 228 patients were enrolled from nine centers in china. Grade≥3,Grade≥2 radiation esophagitis and pneumonitis in the IFI arm were significantly lower than that of the ENI arm(P=0.018,0.027).No significant differences were observed in overall failure rates,loco-regional failure,distant failure rates,in-field and out-field lymph node failure between the two arms(P=0.401,0.561,0.510,0.561,0.681).The 1-,2-, 3-,4-yearand median OS in the ENI arm and IFI arm were 84.1%,57.3%,39.4%,31.6%,28 months and 83.6%,62.1%,44.5%,31.5%,32 months(P=0.654),respectively. The 1-,2-,3-yearand median PFS in the ENI arm and IFI arm were 71.9%,42.3%,32.7%,20 months and 70.1%,45.0%,35.9%,22 months (P=0.885),respectively. Conclusions Compared to ENI,IFI resulted in decreased radiation pneumonitis and esophagitis without sacrificing loco-regional lymph nodal control,PFS and OS in thoracic ESCC. Clinical Trial Registry Chinese Clinical trail registry,registration number:NCT01551589.
