Study on safety of adjuvant radiotherapy concurrent with weekly chemotherapy for stage ⅡB-ⅣA esophageal carcinoma after radical resection
10.3760/cma.j.issn.0253-3766.2019.06.004
- VernacularTitle: 局部晚期食管癌根治术后放疗同步周方案化疗的耐受性研究
- Author:
Wenjie NI
1
;
Shufei YU
2
;
Jinsong YANG
3
;
Wencheng ZHANG
4
;
Zongmei ZHOU
1
;
Hongxing ZHANG
1
;
Dongfu CHEN
1
;
Qinfu FENG
1
;
Jima LYU
1
;
Jun LIANG
1
;
Xiaozhen WANG
1
;
Xin WANG
1
;
Lei DENG
1
;
Wenqing WANG
1
;
Tao ZHANG
1
;
Nan BI
1
;
Zefen XIAO
1
Author Information
1. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
2. Department of Radiation Oncology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
3. Department of Radiation Oncology, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
4. Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Surgery;
Radiation therapy;
Chemotherapy;
Safety
- From:
Chinese Journal of Oncology
2019;41(6):415-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the tolerability and short-term efficacy of chemo-radiotherapy in 125 patients with stage ⅡB-ⅣA esophageal carcinoma after radical resection.
Methods:We retrospectively evaluated the rate of completion, toxicity and survival of patients undergoing adjuvant concurrent chemo-radiotherapy after radical resection of esophageal carcinoma from January 2004 to December 2014 in our institution. The survival rate was determined by the Kaplan-Meier method and analyzed using the log-rank test. Multivariate prognostic analysis was performed using the Cox proportional hazard model.
Results:122 patients received more than 50 Gy dose (97.6%). A total of 52 patients received more than 5 weeks chemo-radiotherapy (41.6%), while 73 patients underwent only 1-4 weeks (58.4%). The median following up was 48.4 months. 8 patients lost follow up (6.4%). The 1-year and 3-year overall survival rate were 91.6% and 57.0%, respectively, with a median survival time of 64.4 months. The 1-year and 3-year disease free survival rate were 73.2% and 54.3%, respectively, with a median disease free survival time of 59.1 months. The most common acute complications associated with chemo-radiotherapy were myelosuppression, radiation esophagitis and radiation dermatitis, the majority of which were Grade 1-2. Of the 125 patients, there were 59 cases of recurrence, including 23 cases with local regional recurrence, 26 cases with hematogenous metastasis, and 8 cases with mixed recurrence. Univariate analysis showed that the numbers of concurrent chemotherapy was associated with the overall survival (P=0.006). But receiving more than 5 weeks was not the prognostic factor compared to 1 to 4 weeks chemotherapy (P=0.231). Multivariate analysis showed that only the numbers of concurrent chemotherapy was an independent prognostic factor (P=0.010).
Conclusions:Postoperative radiotherapy concurrent with weekly chemotherapy could improve the overall survival and decrease the recurrence for stage ⅡB-ⅣA esophageal carcinoma after radical resection. However, the completion rate of chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective randomized controlled trial.
