A randomized controlled study of hypofractionated radiotherapy and conventional fractionated radiotherapy combined with chemotherapy in the treatment of postoperative tracheoesophageal groove lymph node metastasis
10.3760/cma.j.issn.0254-5098.2018.07.008
- VernacularTitle: 大分割和常规分割放疗联合化疗治疗食管癌术后气管食管沟淋巴结转移的随机对照研究
- Author:
Haiwen ZHU
1
;
Jingping YU
2
;
Jianling WANG
2
;
Youqin JIANG
1
;
Dong PEI
1
;
Jian WANG
2
Author Information
1. Department of Radiotherapy, Yancheng No.3 People′s Hospital, Affiliated Hospital of Dongnan University, Yancheng 224001, China
2. Department of Radiotherapy, Changzhou No. 2 People′s Hospital, Affiliated Hospital of Nanjing Medical University, Changzhou 213003, China
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
Tracheoesophageal groove lymph node metastasis;
Hypofractioned radiotherapy;
Conventional fractioned radiotherapy
- From:
Chinese Journal of Radiological Medicine and Protection
2018;38(7):524-528
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficiency and safety of hypofractionated radiotherapy (HFR) combined with chemotherapy using paclitaxel for the treatment of esophageal cancer (EC) patients with post-operative tracheoesophageal groove lymph node (TGLN) metastasis.
Methods:A total of fifty-three post-operative EC patients with TGLN metastasis were randomly divided into HFR group (n=25), receiving a radiation of 60 Gy/20 fractions, and conventional fractionated radiotherapy (CFR) group (n=28), receiving a radiation of 60 Gy/30 fractions combined with chemotherapy using paclitaxel with a dosage of 50 mg once per week through tossing a coin. the adverse events and the prognosis between two groups were compared.
Results:The incidence of radiation esophagitis and pneumonitis (grade 3-4) between the HFR group and CFR group showed no statistically significant difference (44.0%, 25.0%, P>0.05; 16.0%, 7.1%, P>0.05). No statistical difference was noticed in the efficiency between the HFR group and the CFR group (P>0.05). The efficiency in patients with lymph node metastasis at diameters ≤2 cm was significantly higher than that with lymph node metastasis at diameters >2 cm (P<0.05). The median overall survival (OS) of the HFR group showed a significant increase compared with that of the CRF group [24.2 months (95%CI 16.2-32.1 months) vs. 11.8 months (95%CI 9.2-14.4 months)] (χ2=5.063, P<0.05). Both univariate and multivariate analysis indicated that TGLN diameter (P<0.05) and fractioned types (P<0.05) were factors that affected the prognosis.
Conclusions:The combination of HFR and chemotherapy contributed to the improvement of prognosis in EC patients with TGLN metastasis and there was no obvious increase in the adverse events.
Trial registration:Chinese clinical trial registry, ChiCTR1800016848
