Objective To explore the effectiveness and esophageal strictures of concurrent chemoradiotherapy in patients with cervical and upper-thoracic esophageal cancer (EC) and middle-thoracic and lower-thoracic EC.Methods Between January 2011 and December 2014,ninety patients with different parts of EC were treated with radiotherapy combined with concurrent chemotherapy in People's Hospital of Subei.The median irradiation dose was 60 Gy.The chemotherapy regimens consisted of Paclitaxel and Nedaplatin.Of all the patients,48 patients had cervical and upper-thoracic EC,42 patients had middle-thoracic and lowerthoracic EC.The response rates,the local control rates,the survival rates and esophageal strictures were evaluated between two groups.Results The follow-up rate was 100％.The response rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 81.2％ and 73.8％ (x2 =0.717,P =0.397),respectively.The 1-year local control rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 90.3％ and 71.8％ (x2 =5.865,P =0.015),respectively.The 1-year survival rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 87.5％ and 69.0％ (x2 =4.580,P =0.032),respectively.The moderate-to-severe esophageal strictures rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 55.6％ and 29.4％ (x2 =5.360,P =0.021),respectively.There were no significant differences in shortterm effects between the cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC.The patients with cervical and upper-thoracic EC showed significantly higher 1-year local control rates,1-year survival rates and esophageal strictures rates than those with middle-thoracic and lower-thoracic EC.Conclusion The effectiveness of concurrent chemoradiotherapy is better in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC,but the esophageal stenosis is more severe in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC.

Objective: To investigate the percentage of myeloid-derived suppressor cells (MDSC) and T regulatory cells (Treg) in peripheral blood of nasopharyngeal cancer (NPC) patients undergoing concurrent chemoradiotherapy or radiotherapy alone. Methods: Sixty NPC patients who received radiotherapy or concurrent chemoradiotherapy from September 2012 to November 2015 and 20 healthy individuals were included in this study. For the patients, the blood samples were collected at four time points: pre-radiation (Pre-RT), reaching a dose of 40 Gy (RT-40 Gy), finishing radiation (RT-finish) and three months after finishing radiation (3m-post-RT). Flow cytometry was used to evaluate the percentage of Treg (CD4⁺ CD25⁺ CD127^low/-) and MDSC (HLA-DR^-CD11b⁺ CD33⁺ ) cells in peripheral blood. Results: Treg and MDSC cells were present in peripheral blood lymphocytes of healthy individuals as a percentage of (7.50±1.62)% and (1.08±0.48)%, respectively. The proportions of peripheral Treg cells in patients at Pre-RT, RT-40 Gy, RT-finish and 3m-post-RT time points were (8.42± 1.52)%, (9.10±1.57)%, (8.87±1.56)% and (7.31±1.43)%, respectively, showing a statistically significant difference between Pre-RT and the other groups (P<0.05). At Pre-RT point, the percentage of Treg cells in Stage Ⅲ-Ⅳ patients [(8.63±1.39)%] was higher than that in Stage Ⅰ-Ⅱ [(7.65±1.94)%, P=0.042]. Moreover, the proportions of peripheral MDSC cells in patients at Pre-RT, RT-40 Gy, RT-finish and 3m-post-RT time points were (2.14±1.21)%, (4.08±1.90)%, (3.76±1.31)% and (1.52±0.88)%, respectively. The percentages of MDSC cells at RT-40 Gy and RT-finish points were significantly higher than those at Pre-RT, while the percentage of MDSC cells at 3m-post-RT was significantly lower than those at Pre-RT (P<0.05). At Pre-RT point, the percentage of MDSC cells in Stage Ⅲ-Ⅳ patients [(2.25±1.26)%] was higher than that in Stage Ⅰ-Ⅱ [(1.35±0.66)%, P=0.007]. At RT-finish point, the proportions of MDSC and Treg cells in patients with Ⅲ-Ⅳ grade of radiation induced oral mucositis [(4.41±1.27)% and (9.91±1.23)%] were significantly higher than those in Ⅰ-Ⅱ grade patients [(3.15±1.04)% and (8.41±1.52)%, both of P<0.05]. Conclusions The proportions of MDSC and Treg cells in initial treated NPC patients are higher than healthy individuals, and they are also associated with the tumor stages. During the concurrent chemoradiotherapy and radiation, the percentage of MDSC and Treg cells is elevated, suggesting a decreased immune activity. The increase of MDSC and Treg cells is related to radiation induced oral mucositis.