| Shen Wenbin,Gao Hongmei,Xu Jinrui,et al.Prognosis and failure patterns of esophageal squamous cell carcinoma patients undergoing selective lymph node irradiation[J].Chinese Journal of Radiological Medicine and Protection,2020,40(3):196-202 |
| Prognosis and failure patterns of esophageal squamous cell carcinoma patients undergoing selective lymph node irradiation |
| Received:July 04, 2019 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.03.007 |
| KeyWords:Esophageal neoplasms/esophageal squamous cell carcinoma Intensity modulated conformal radiotherapy Elective nodal irradiation Prognosis Failure mode |
| FundProject:首都卫生发展科研专项（首发2018-4-1027）；北京市自然科学基金（7172048）；教育部科技发展中心产学研创新基金-"智融兴教"基金（2018A01019）；国家自然科学基金（11505012）；四川省科技计划资助（2018HH0099）；北京市属医院科研培育计划项目（PX2019042）；北京市医院管理局"青苗"计划专项经费（QML20171104） |
| Author Name | Affiliation | E-mail | | Shen Wenbin | Department of Radiation, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Gao Hongmei | Image Center, Shijiazhuang First Hospital, Shijiazhuang 050011, China | | | Xu Jinrui | Department of Radiation, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Li Shuguang | Department of Radiation, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Li Youmei | Department of Radiation, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhu Shuchai | Department of Radiation, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | sczhu1965@163.com |
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| Abstract:: |
| Objective To investigate the prognosis and failure mode of patients with esophageal squamous cell carcinoma receiving selective lymph node irradiation (ENI). Methods A total of 179 eligible patients with esophageal squamous cell carcinoma were retrospectively analyzed. The prognostic value of tumor-related factors, the influencing factors of short-term curative effect and prognosis of patients, and the single and multi factor indexes of affecting the overall survival rate (OS), progression free survival rate (PFS) and recurrence of patients were analyzed.SPSS 19.0 software was used for statistical analysis. Results The 1,3- and 5-year OS of the whole group were 77.1%, 40.1% and 26.0%,respectively, and 1-,3- and 5-year PFS were 62.6%,30.6%,and 20.3%, respectively. Multivariate analysis showed that hoarseness, cN stage, cTNM stage, GTV-transverse diameter (GTV-D) and GTV-volume/length (GTV-V/L) were independent factors affecting OS (P<0.05). The sonar, cTNM staging, and short-term efficacy were independent factors affecting PFS (P<0.05).Recurrence occurred in 75 patients (41.9%) in the whole group, and 61 patients (34.1%) had distant metastases. Among them, 9 patients (10.6%) had both recurrence and distant metastasis. Of the 75 patients with recurrence, 64(85.3%) had simple esophageal recurrence,4(5.3%) had lymph node recurrence, and 7 (9.3%) had both. Recurrence occurred in 18 of the 63 patients who achieved CR after treatment. Only 2 patients had lymph node recurrence. Logistic multivariate analysis showed that the surrounding tissue/organ invasion, GTV-D and short-term were independent factors affecting the recurrence rate (P<0.05). Conclusions ENI is feasible in patients with esophageal squamous cell carcinoma, and the main mode of failure is esophageal recurrence. Pre-treatment sonar, larger GTV-D and GTV-V/L, more advanced clinical stage and poorer short-term efficacy are indicators of poor prognosis, while the peripheral tissue involvement, GTV-D and short-term efficacy are the independent factors that influence failure. |
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