ABSTRACT
Objective To evaluate the efficacy and side effects of extensive regional field radiotherapy concurrent with chemotherapy for locally advanced esophageal cancer.Methods Of the 101 patients with locally advanced esophageal cancer patients,44 patients were treated by involved field radiotherapy alone,29 patients treated by involved field radiotherapy combined with chemotherapy,and 28 patients received extensive regional field radiotherapy combined with chemotherapy,the total dose of radiotherapy was 60 Gy.The clinical target volume (CTV) of involved field included the gross tumor volume (GTV) plus a 0.8 cm lateral margin,the tumor plus a nominal 3-5 cm cephalad and caudal margin.Extensive regional field radiotherapy was delivered in two steps:the CTV included the CTV of the involved field plus elective nodal region in the first step;in the second step,the CTV definition was same with the CTV of the involved field.Synchronous chemotherapy regimens included TP and NP.Results 90.1％patients completed planned radiotherapy,all patients in the concurrent chemotherapy groups completed at least one cycle of chemotherapy.The follow-up rate was 99％.Twenty-four and 42 patients completed followed-up more than 24 months in the radiotherapy alone and concurrent chemoradiotherapy group,respectively.The median survival time of the involved field radiotherapy group,involved field chemoradiotherapy group and extensive regional field chemoradiotherapy group was 13,21 and 19 months,respectively;the 2-year overall survival (OS) rate was 15％,48％ and 46％,respectively for the three groups.The 2-year OS rate was improved significantly in the chemoradiotherapy group (x2 =6.83,P =0.033).Compared with radiotherapy alone group,the incidence of grade three or four bone marrow suppression was higher in the concurrent chemoradiotherapy group (53％: 0 ％,x2 =32.94,P =0.000),the remaining adverse events (acute radiation pneumonitis,acute radiation esophagitis,esophageal fibrosis,late radiation lung injury) had no significant intergroup differences (x2 =5.56,6.70,2.39,0.42,P =0.235,0.349,0.881,0.981).Conclusions Compared with radiotherapy alone,concurrent chemoradiotherapy can improve the survival rate for locally advanced esophageal cancer.The side effects of the extensive regional field radiotherapy combined with chemotherapy is well tolerated.But the efficacy of the extensive regional field radiotherapy combined with chemotherapy needs further research.
ABSTRACT
Objective To seek an effective and feasible treatment for esophageal carcinoma with unequal fractionation radiotherapy.Methods 160 patients with esophageal squamous carcinoma were randomized into an unequal frationation radiotherpy (UEFRT) group and a conventional fractionation radiotherapy (CFRT) group with 80 cases on each side. All the patients were simulated and irradiated by three port technique. Patients in the UEFRT group received D T70 Gy, at 4 Gy once daily, 5 days in the first week, then at 2 Gy daily, 5 days per week during the following five weeks. In the CFRT group,70 Gy was delivered with the routine regimen. Results The 5 year local control rates in UEFRT and CFRT groups were 46.3% and 27.5%(P
ABSTRACT
Objective To define the correlation between the proliferating cell nuclear antigen (PCNA) and metastasis-related gene nm-23-H 1, and to correlate their espressions with clinical features,radiosensitivity and prognostic variables in exophageal squamous cell carcinoma (ESCC), to establish some biological parameters obtained prior to therapy though which we can predict radiosensitivity and outcome.Methods PCNA and nm-23-H 1 expression protein were determined by immunohistochemical technique with formalin-fixed paraffin-embedded specimens from 59 patients with ESCC who had received definitive radical radiation and had been followed up for more than 3 years. The values were assessed by distributions of patients , disease factors, including age,sex,lesion site,legth ,histological grade and prognosis.Results The findings showed that the mean labelling indices of PCNA and nm-23-H 1 were significantly higher in ESCC than in the normal esophageal tissue (P0.05).Conclusions PCNA and nm-23-H 1 indices can be taken as biological endpoints to predicting therapeutic response, local and systemic control of disease.