| Li Qiaofang,Zhu Shuchai,Deng Wenzhao,et al.Clinical outcomes in different target volume for cervical and upper-thoracic esophageal cancer in definitive chemoradiotherapy[J].Chinese Journal of Radiological Medicine and Protection,2019,39(4):268-273 |
| Clinical outcomes in different target volume for cervical and upper-thoracic esophageal cancer in definitive chemoradiotherapy |
| Received:September 21, 2018 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.04.005 |
| KeyWords:Esophageal cancer Elective nodal irradiation(ENI) Involved-field irradiation(IFI) Definitive chemoradiotherapy Prognostic factors |
| FundProject: |
| Author Name | Affiliation | E-mail | | Li Qiaofang | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhu Shuchai | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | sczhu1965@163.com | | Deng Wenzhao | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhang Xueyuan | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Song Chunyang | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Wang Xuan | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Yan Ke | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | |
|
| Hits: 3487 |
| Download times: 1747 |
| Abstract:: |
| Objective To investigate the prognostic effects and failure patterns of different clinical target volumes of IMRT in definitive chemoradiotherapy for cervical and upper-thoracic esophageal cancer, in order to provide a reference for radiotherapy target area delineation. Methods A retrospective analysis was performed on the clinical data of 132 patients with cervical and upper-thoracic esophageal cancer who received definitive IMRT and concurrent chemotherapy in our hospital from 2010 to 2014. Seventy-one patients received elective nodal irradiation (ENI) and the other 61 patients received involved-field irradiation (IFI). The Kaplan-Meier method was used to calculate local control (LC), progression-free survival (PFS) and overall survival (OS) rates. The significant difference was evaluated by the log-rank test. The prognostic factors were determined by Cox univariate and multivariate analyses. Results The last follow-up time was December 2017, the median follow-up time was 59.5 (14.2-95.8) months. Follow-up rate was 99.2%. For the ENI and IFI groups, the 1-, 3-, 5-year LC were 77.5%, 58.8%, 48.8% vs. 64.3%, 29.1%, 26.2% (χ2=9.68, P=0.002), PFS were 68.6%, 37.7%, 25.9% vs. 47.5%, 17.2%, 3.6% (χ2=11.39, P=0.001), OS were 81.7%, 53.9%, 31.3% vs. 70.5%, 31.9%, 16.3% (χ2=7.70, P=0.006), respectively. In multivariate analysis, T stage, N stage, and RT field were independent factors for LC, PFS and OS(P<0.05). The total failure rates, local-regional recurrent rate in ENI group were lower than those in IFI group (χ2=13.23, 5.24, P<0.05). No significant differences were found in acute radiation esophagitis, pneumonitis and myelosuppression (Grades ≥ 3) between the two groups(P>0.05). Conclusions Compared with IFI, ENI can significantly reduce local-regional recurrence and distant metastasis and improve the long-term survival for cervical and upper-thoracic esophageal cancer patients who received definitive chemoradiotherapy. |
| HTML View Full Text View/Add Comment Download reader |
| Close |
|
|
|
