Effects of different irradiation ranges in definitive intensity-modulated radiotherapy combined with chemotherapy on prognosis of patients with esophageal cancer
10.3760/cma.j.cn113030-20191009-00407
- VernacularTitle:食管癌根治性调强放疗＋化疗照射靶区范围对预后的影响
- Author:
Qiaofang LI
1
;
Wenzhao DENG
;
Yan ZHAO
;
Chunyang SONG
;
Jinrui XU
;
Xuan WANG
;
Shuchai ZHU
Author Information
1. 河北医科大学第四医院放疗科，石家庄 050011；河北省人民医院肿瘤科，石家庄 050011
- From:
Chinese Journal of Radiation Oncology
2020;29(7):513-518
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of different irradiation ranges in definitive intensity-modulated radiotherapy (IMRT) combined with chemotherapy on the survival of esophageal cancer patients.Methods:Clinical data of 360 esophageal cancer patients who received definitive chemoradiotherapy in the Fourth Hospital of Hebei Medical University from 2006 to 2015 were retrospectively analyzed. Among them, 131 patients received elective nodal irradiation (ENI) and 229 patients underwent involved-field irradiation (IFI). Platinum-based chemotherapy was adopted. The overall survival (OS) rate was analyzed by Kaplan- Meier method and Logrank test. Results:Until the final follow-up at the end of December 2018, the follow-up rate was 96%. The median follow-up time was 64 months (95% CI: 53-76). The median survival time was 24 months (95% CI: 20-28). The 1-, 3-, 5-year OS rates were 76.1%, 38.7% and 21.0%, respectively. After propensity score matching, the 1-, 3-, 5-year OS rates were 83.9%, 48.6%, 26.8% vs. 74.0%, 33.8%, 17.5% between the ENI ( n=131) and IFI groups ( n=131)( P=0.011), respectively. Subgroup analysis showed that patients with male, aged≤66 years, cervical and upper-thoracic location, tumor length≤7 cm, tumor volume≤50 cm 3, T 1-3 stage, dosage>60 Gy and concurrent chemoradiotherapy obtained better OS rates in the ENI group than their counterparts in the IFI group (all P<0.05). In the ENI group, the total failure rate, locoregional failure rate and distant metastasis rate were significantly lower, whereas the incidence of ≥Grade Ⅲ myelosuppression was remarkably higher than those in the IFI group (all P<0.05). Conclusion:Compared with IFI, ENI can significantly improve the survival for patients with early-stage and cervical and upper-thoracic esophageal cancer receiving definitive IMRT combined with chemotherapy.
