| WANG Dong-qing,SUN Ming-ping,LI Bao-sheng,et al.Late course accelerated hyperfractionated radiotherapy plus concurrent cisplatin-based chemotherapy for locally advanced esophageal squamous cell carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2013,33(6):615-618 |
| Late course accelerated hyperfractionated radiotherapy plus concurrent cisplatin-based chemotherapy for locally advanced esophageal squamous cell carcinoma |
| Received:February 21, 2013 |
| DOI：10.3760/cma.j.issn.0254-5098.2013.06.012 |
| KeyWords:Esophageal squamous cell carcinoma Late course accelerated hyperfractionated radiotherapy Chemotherapy |
| FundProject:山东省科技攻关计划（2007Hz102） |
| Author Name | Affiliation | E-mail | | WANG Dong-qing | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | SUN Ming-ping | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | LI Bao-sheng | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | baoshli@yahoo.com | | WANG Zhong-tang | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | | | WEI Yu-mei | Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China | |
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| Abstract:: |
| Objective To evaluate the treatment efficacy and treatment-related toxicity of late course accelerated hyperfractionated radiotherapy (LCAHRT) combined with cisplatin-based chemotherapy (CHT) for locally advanced esophageal squamous cell carcinoma (ESCC). Methods A total of 46 patients with histologically confirmed ESCC, 11 in the stage Ⅱa, 3 in the stage Ⅱb, and 32 in the stage Ⅲ, underwent conventional fractioned radiation of 40 Gy in 20 fractions on the primary and metastatic lymph nodes, and high-risk lymph node drainage regions, and then the primary and metastatic lymph nodes were irradiated as boost with an additional dose of 19.6 Gy in 14 fractions (1.4 Gy twice a day), and the total prescribed dose was 59.6 Gy in 34 fractions. Two cycles of CHT were administered concurrently during the radiotherapy. The 1-, 3-, and 5-year overall survival (OS) rates and local control rates (LCRs) were evaluated by Kaplan-Meier method, and treatment-related toxicity was analyzed based on the RTOG and CTCAE criteria 3.0. Results All patients received the whole course of treatment. The median follow-up time was 34.4 months (6-67 months). The overall response rate was 91.3% (42/46). The median OS was 38.5 months (95% CI 29.6-47.4 months). The 1-, 3-, and 5-year OS rates and LCRs were 78.6%, 49.4%, and 39.9%, and 84.3%, 68.2%, and 61.4% respectively. The incidence of ≥G3 radiation-induced esophagitis was 23.9%. Three kinds of serious (≥G3) hematologic toxicities were recorded, including leucopenia (26.1%), thrombocytopenia (13.0%), and anemia (10.9%). Esophagotracheal fistula was recorded in 2 patients (4.3%). Conclusion LCAHRT plus CTH can be favorable for the patients with locally advanced ESCC, however, the treatment-related toxicities may be serious. |
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