ABSTRACT
Objective To evaluate and compare the clinical outcomes of concurrent chemoradiotherapy with different radiation doses for esophageal carcinoma. Methods 78 cases of esophageal carcinoma receiving primary definitive treatment in our department between May 1 , 2005 to June 31 2007 were analyzed retrospectively. The patients with esophageal carcinoma were divided into high- ( > 50 Gy, median dose of 64 Gy) and low-dose (50 Gy) groups according to their prescription doses (n = 35, 43, respectively). Chemotherapy regimen consisted of cisplatin (75 mg/m2, d1) and 5-FU (500 ~ 600 mg/m2, D2 ~ 5) starting at days 1, 28, 49 and 70 after the beginning of radiotherapy with 2 ~ 4 cycles. The two groups were compared in terms of the early treatment outcomes, the side effects and survival rates. Results The 1,3 and 5-year survival rates for the high and low dose groups were 71.4%, 34.3%, 25.7%and 76.7%, 41.9%, 30.2%, respectively. The median survival time was 19 and 22 months respectively without statistical difference. The high dose group was more likely to have higher incidence rate of grade Ⅲ to Ⅳ myelosuppression in spite of the statistical difference. The high dose group had significantly higher incidence of esophagitis than did the low dose group (P=0.040). Conclusion For esophageal carcinoma with only indications of concurrent chemoradiotherapy, te low dose radiation (50 Gy) has comparable outcomes and less side effects compared with the high dose radiation (>50 Gy).
ABSTRACT
Objective To investigate the local-regional recurrence of nasopharyngeal carcinoma (NPC) 5 years after conventional radiotherapy and its prognosis.Methods From August 1989 to Decem ber 1999,1384 patients with newly histo-pathologicatly diagnosed NPC were treated with conventional radia tion.350 out of 1277 followed-up patients were diagnosed as local-regional failure.The intervals between completion of radiation and tumor relapse ranged from 6 months to 171 months.There were 62 patients with local-regional recurrence 5 years after the radiotherapy,including 41 in nasopharynx,19 in neck and 2 in na sopharynx and neck simultaneously.Thirty-seven patients with late local-regional recurrence received a sec ond course conventional radiotherapy.Results The median survival time was 44 months(95% CI = 30.4 -57.6) of patients with re-irradiation comparing with 14 months (95% CI = 7.1-20.8) of those without. The 5 year survival rate after re-irradiation was 42%.Conclusions Local-regional recurrence of nasopha ryngeal carcinoma can oeoure 5 years after radiotherapy.Second course converntional radiotherapy possesses good results.