| Bei Yanping,Yan Danfang,Yan Senxiang,et al.The feasibility of involved-field irradiation in old patients with esophageal squamous-cell carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2015,35(7):510-513,558 |
| The feasibility of involved-field irradiation in old patients with esophageal squamous-cell carcinoma |
| Received:November 15, 2014 |
| DOI：10.3760/cma.j.issn.0254-5098.2015.07.007 |
| KeyWords:Esophageal cancer Involved field irradiation Elective nodal irradiation Radiation pneumonitis |
| FundProject:浙江省公益技术研究社会发展项目(2013C33G2010258);国家自然科学基金面上项目(81172124) |
| Author Name | Affiliation | E-mail | | Bei Yanping | Department of Radiation Oncology, First Affiliated Hospital to College of Medicine, Zhejiang University, Hangzhou 310003, China | | | Yan Danfang | Department of Radiation Oncology, First Affiliated Hospital to College of Medicine, Zhejiang University, Hangzhou 310003, China | | | Yan Senxiang | Department of Radiation Oncology, First Affiliated Hospital to College of Medicine, Zhejiang University, Hangzhou 310003, China | yansenxiang@zju.edu.cn | | Lu Miaozhen | 宁波市医疗中心李惠利医院放疗科 | | | Liu Kaitai | 宁波市医疗中心李惠利医院放疗科 | |
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| Abstract:: |
| Objective To assess the outcomes of involved field irradiation (IFI) and elective nodal irradiation (ENI) in patients older than 70 years with esophageal squamous-cell carcinoma(SCC)receiving radical IMRT, and to determine whether IFI is feasible in these patients. Methods Totally 79 patients older than 70 years diagnosed with SCC of esophagus without distant metastases were collected. 48 patients were received IFI, and the other 31 patients were treated with ENI. With a median follow-up time of 24 months, disease-free survival, overall survival, patterns of failure, irradiated lung dose and radiation pneumonitis were observed and compared between IFI and ENI groups. Results In IFI and ENI arm, the disease-free survival rates of 1, 2,3 years were 60.4%,34.9%,29.7% and 64.5%,54.0%, 35.0%, respectively(P>0.05).The 1-, 2-, and 3-year survival rates were 72.9%, 43.4%, 31.5% for the IFI arm, and 73.0%,53.0%,38.3% for the ENI arm(P>0.05). The ENI arm had a tendency to expand survival, but the two arms had no significant difference(P>0.05). The patterns of failure also had no difference between the two arms. Distant failure,local failure,uninvolved nodal failure in IFI arm were 22.9%,27.0%,4.2%,while in ENI arm were 25.8%,0,19.4%,all of them had no significant difference(P>0.05). However, the lung V5, V20, mean lung dose in ENI arm were higher than that in IFI and all of them had a significantly difference(t=4.66, 29.90, 15.63, P<0.05). The radiation pneumonitis rates were higher in ENI than in IFI arm. The rates of degree 1-2 and degree 3 were 22%, 19%,and 13% and 4% in the two arms, respectively, with a significantly difference(χ2=4.55, 4.77, P<0.05). Conclusions It is feasible that IFI for definitive IMRT in the elderly patients older than 70 years with SCC,because it got similar disease-free survival and overall survival but with less lung doses along with decreased radio-pulmonary lesion when compared with ENI. |
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