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Objective This study was conducted to evaluate treatment-related toxicities,the patterns of failure,overall survival(OS)and progression-free survival(PFS)by comparing IFI with ENI in combination with chemotherapy. Methods Eligible patients were treated with concurrent chemoradiotherapy and randomized into either an IFI or ENI arm. The primary end points wereacute treatment-related toxicities. The secondary end points were patterns of failure,OS and PFS. Kaplan?Meier survival rate of the method for calculating the Logrank test difference method. Results Between April 2012 and October 2016,a total of 228 patients were enrolled from nine centers in china. Grade≥3,Grade≥2 radiation esophagitis and pneumonitis in the IFI arm were significantly lower than that of the ENI arm(P=0.018,0.027).No significant differences were observed in overall failure rates,loco-regional failure,distant failure rates,in-field and out-field lymph node failure between the two arms(P=0.401,0.561,0.510,0.561,0.681).The 1-,2-, 3-,4-yearand median OS in the ENI arm and IFI arm were 84.1%,57.3%,39.4%,31.6%,28 months and 83.6%,62.1%,44.5%,31.5%,32 months(P=0.654),respectively. The 1-,2-,3-yearand median PFS in the ENI arm and IFI arm were 71.9%,42.3%,32.7%,20 months and 70.1%,45.0%,35.9%,22 months (P=0.885),respectively. Conclusions Compared to ENI,IFI resulted in decreased radiation pneumonitis and esophagitis without sacrificing loco-regional lymph nodal control,PFS and OS in thoracic ESCC. Clinical Trial Registry Chinese Clinical trail registry,registration number:NCT01551589.
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Objective To investigate the expressions of AGGF1 in esophageal squamous cell carcinoma (ESCC) and their relationships with clinical features and prognosis of ESCC. Methods The expressions of AGGF1 in 70 cases of ESCC and 30 cases of normal esophageal tissue were examined using SP immunohistochemical staining and were analyzed according to the clinical features and follow-up data. Results The expressions of AGGF1 in 70 cases of ESCC was significantly higher than those in 30 cases of normal esophageal tissue [54.29%(38/70) vs. 23.33%(7/30)](P=0.004). The expressions of AGGF1 in ESCC were significantly related to the TNM stage, clinical stage and prognosis (P all<0.05). The OS was shorter in the positive teams of AGGF1 than that in the negative teams [(19.7 ± 3.5) months vs. (33.2 ± 4.0) months] (P=0.015). Cox- proportional multivariate analysis showed that positive expressions of AGGF1 and VEGF (P=0.043, 0.024) and clinical stage (P=0.035) were significant prognostic factors in overall survival. Conclusions AGGF1 has high expressions in ESCC, and it is closely related to the clinical features and prognosis of ESCC.
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Objective To explore the nutritional increased risk related factors in esophageal cancer patients after chemoradio‐therapy .Methods Sixty‐eight esophageal cancer patients undergoing concurrent chemoradiotherapy were prospectively investiga‐ted .The patient‐generated subjective global assessment(PG‐SGA) was adopted to grade the nutritional risk .All of the patients re‐ceived early nutrition education and short‐term nutrition support for severe malnutrition ,nutritional status was assessed again at the end of radiotherapy .The patients were divided into the mild‐to‐moderate malnutrition group[PG‐SGA(B)group] and the severe malnutrition group [PG‐SGA(C)group] according to the PG‐SGA score on admission .The body mass ,albumin(Alb) ,hemoglobin (Hb) ,white blood cells ,platelets ,neutrophils ,lymphocytes ,monocytes and other objective nutrition indicators were collected before and after chemoradiation .Results There were 24 cases in the PG‐SGA(B) group and 44 cases in the PG‐SGA(C) group;the gen‐der ,age and ethnic had no statistical differences between the two groups(P>0 .05) .Hb(χ2 =2 .710 ,P=0 .009) and Alb(χ2 =3 .743 ,P=0 .000) before chemoradiotherapy had no statistical difference between the two groups(P>0 .05);Hb and Alb after che‐moradiotherapy in the PG‐SGA(B) group were higher than those in the PG‐SGA(C) group .The body mass index(BMI)before and after chemoradiotherapy had statistically significant difference between the two groups (P<0 .05) .The percentage of body mass decrease in the two groups had no statistical significance (P=0 .487) .The PG‐SGA scores after chemoradiotherapy were positively correlated with the change of Hb ,Alb ,BMI parameters and percentage of weight decrease before and after chemoradiotherapy(rs=0 .240 ,0 .249 ,0 .282 ,0 .447 ,P<0 .05) .Conclusion The poor understanding of malnutrition ,the change of Hb ,Alb ,BMI parame‐ters and percentage of body weight decrease before and after chemoradiotherapy are the nutritional increased risk factors in esopha‐geal cancer patients after chemoradiotherapy .
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Objective To study the effect of radiotherapy and prognostic factors for patients with post-operative loco-regional recurrence of esophageal carcinoma. Methods From 2000 to 2005,91 patients with esophageal carcinoma who developed post-operative loco-regional recurrence were analyzed retrospectively. The interval between surgery and recurrence was 1 -35 months, with a median interval of 11.1 months. There were 4 patients with anastomosis relapse, 6 with anastomosis and mediastinal lymph nodes relapse,4 with abdominal lymph node relapse, 20 with supra-clavicular lymph node relapse, 34 with mediastinal lymph node relapse, and 23 with mediastinal and supra-clavicular lynph node relapse. There were 56 and 35 patients who received conventional and three-dimensional conformal radiation therapy respectively, with a total radiation dose of 50 -70 Gy. Sixty-eight patients received adjuvant chemotherapy.Results The follow-up rate was 95%. The 1-,2-and 3-year overall survival rates were 52%, 20% and 14%, respectively. In univariate analysis, the recurrence time (P = 0. 001), postoperative stage (P =0. 000), radiation dose (P =0. 001) ,overall response rate (P =0. 000) ,T stage (P =0. 028), and N stage (P = 0. 003) were related with prognosis. Multivariate analysis showed that the recurrence time (P =0. 014), postoperative stage (P = 0. 006), radiation dose (P = 0. 009), overall response rate (P = 0. 000)were independent prognostic factors for survival. Conclusions Radiotherapy may improve the survival of esophageal carcinoma patients with postoperative recurrence. Patients with long recurrence-free time, early stage, high response rates, and radiation dose of higher than 60 Gy have better prognosis.