| Jiang Chenxue,Chen Wucheng,Han Shuiyun,et al.Comparison of efficacy between trimodality and chemoradiation therapy alone in treatment of locally advanced esophageal squamous cell carcinoma[J].Chinese Journal of Radiological Medicine and Protection,2018,38(3):192-196 |
| Comparison of efficacy between trimodality and chemoradiation therapy alone in treatment of locally advanced esophageal squamous cell carcinoma |
| Received:November 24, 2017 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.03.006 |
| KeyWords:Esophageal squamous cell carcinoma Trimodality therapy Preoperative chemoradiotherapy Postoperative chemoradiotherapy Definitive chemoradiotherapy |
| FundProject: |
| Author Name | Affiliation | E-mail | | Jiang Chenxue | First Clinical Medical School, Wenzhou Medical University, Wenzhou 325035, China | | | Chen Wucheng | First Clinical Medical School, Wenzhou Medical University, Wenzhou 325035, China | | | Han Shuiyun | Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China | | | Zhu Xiang | Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China | | | Sun Xiaojiang | Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, China | | | Xu Yaping | First Clinical Medical School, Wenzhou Medical University, Wenzhou 325035, China | xuyaping1207@163.com | | Chen Qixun | Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China | | | Mao Weimin | Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, China | |
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| Abstract:: |
| Objective To compare the efficacy of trimodality therapy and chemoradiation therapy(CRT) alone in patients with locally advanced resectable esophageal squamous cell carcinoma (SCC). Methods A total of 124 cases with locally advanced resectable esophageal SCC were retrospectively analyzed and classified into 2 groups. Fifty-four cases in trimodality group were treated with surgery and preoperative chemoradiation, while 70 cases in CRT alone group only received radiation and chemotherapy. Local tumor control, 3-year survival and treatment-related mortality were assessed. Results The local recurrent rate of the resected patients was 18.5% in trimodality group and 35.7% in CRT alone group, respectively(χ2=4.445, P<0.05). The 3-year progression-free survival (PFS) was 65.3% (95%CI 50.7-80.5) in trimodality group and 31.9% (95%CI 19.6-44.2) in CRT alone group (P<0.05), while the overall survival (OS) 66.3%(95%CI 43.0-89.6) and 34.4%(95%CI 21.1-47.7), respectively(P<0.05). Treatment-related mortality was 1.9% in trimodality group and 2.9% in CRT alone group (P>0.05). For CRT alone group, the sub-group analysis showed that there was no statistically significant difference in the 3-year OS between patients who received 50-50.4 Gy and those who received the dose over 50.4 Gy (39.9% 95%CI 18.5-61.3 vs. 31.5% 95%CI 14.8-48.2, P>0.05). Conclusions Compared with CRT alone, trimodality therapy showed the superior local control, PFS and OS, with similar treatment-related mortality in the treatment of patients with SCC of esophagus. The role of surgery could not be replaced by CRT alone even with the augment of radiation dose. |
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