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Objective:To analyze the efficacy and prognostic factors of radiotherapy combined with asparaginase/peaspartase-based chemotherapy regimen in the treatment of early stage extranodal natural-killer/T cell lymphoma of the upper aerodigestive tract (UADT ENKTCL).Methods:267 early stage UADT ENKTCL patients were treated in Guizhou Cancer Hospital from October 2003 to February 2020. Among them, 229 patients received radiotherapy or radiotherapy combined with menpartaminase/permenidase-based chemotherapy regimen and 38 patients were treated with radiotherapy or chemotherapy alone. The overall survival (OS) and progression-free survival (PFS) were calculated by Kaplan- Meier method, log-rank test was conducted for univariate analysis and Cox regression model was performed for multivariate analysis. Results:The 5-year OS and PFS were 67.2% and 61.5% in all patients. The 5-year OS and PFS in patients treated with radiotherapy combined with chemotherapy, radiotherapy alone and chemotherapy alone were 71.7%, 35% and 49%(all P<0.001), and 66.4%, 35% and 28%(all P<0.001), respectively. According to the NRI risk stratification, 246 patients treated with radiotherapy and chemotherapy were divided into the favourable and the unfavourable prognosis groups. The 5-year OS was 93.3% and 64.3%( P<0.001) and the 5-year PFS was 91.1% and 56.7%( P<0.001) in two groups. For patients receiving radiotherapy with a dose ≥50 Gy and<50 Gy, the 5-year OS was 72.4% and 55.7%( P<0.001), and the 5-year PFS was 68.3%, and 36.5%( P<0.001). In the unfavourable prognosis group, the 5-year OS of patients receiving ≥ 4 and<4 cycles of chemotherapy was 65.5% and 59.2%( P=0.049), and the 5-year PFS was 60.7% and 50.6%( P=0.018). Univariate analysis showed that stage Ⅱ, ECOG≥2, primary tumor invasion, radiotherapy alone, NRI≥1(Nomogram-revised risk index), EBV-DNA≥2 750 copies/ml, radiotherapy dose < 50 Gy, and<4 cycles of chemotherapy were associated with unfavorable 5-year OS and PFS (all P<0.05), and CHOP-like regimen was the risk factor of unfavorable 5-year PFS ( P<0.05). Multivariate analysis demonstrated that primary tumor invasion, ECOG≥2, and radiotherapy dose <50 Gy were associated with unfavorable OS and PFS (all P<0.05), and stage Ⅱ was the risk factor of unfavorable 5-year OS ( P<0.05). Conclusions:The prognosis of early stage low-risk UADT ENKTCL of is favourable. Sufficient dose of extended involved-field radiotherapy is an important curative modality in early stage UADT ENKTCL. Compared with radiotherapy alone, radiotherapy combined with chemotherapy can significantly improve the prognosis of early stage UADT ENKTCL patients in the unfavourable prognosis group. Full-course chemotherapy can significantly prolong the long-term survival in the unfavorable prognosis group. The chemotherapy containing asparaginase can significantly enhance the prognosis of patients with early stage UADT ENKTCL.
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Objective:To compare the influence of three-dimensional conformal radiotherapy and radiotherapy combined chemothera-py on the prognosis of patients with advanced esophageal cancer. Methods:A retrospective analysis from June 2007 to June 2010 in our hospital was conducted on 245 patients. Depending on the treatment, patients were classified into simple radiotherapy group and chemoradiothearapy group ,both of which received three-dimensional conformal radiotherapy. A total of 173 patients were in the radi-ation and chemotherapy combined treatment group, while 72 cases were in the simple radiothearapy group. One month after inter-vention, efficacy, adverse reactions, and survival rates of the two groups of patients were compared. Results:The proportion of wom-en in the combination therapy group, aged 0.05). The combined treatment group results were significantly higher than the efficiency of the radiotherapy group. The difference was statistically significant (P0.05). The five-year survival rate of combination group were significantly higher than that of the radiotherapy group, and the difference was statistically significant (P<0.05). Conclusion:For advanced esophageal car-cinoma patients, radiotherapy and chemotherapy combined with radiotherapy improved efficiency of treatment and effectively im-proved survival rate. Although the proposed treatment could lead to adverse reactions, these effects are within the range of tolerance, which makes the said treatment worthy of clinical promotion.
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Objective To evaluated the treatment results of late-course accelerated hyperfractionated radiotherapy combined with chemotherapy for advanced esophageal carcinoma. Methods 72 patients with advanced esophageal cancer were randomized into two groups. The late-course accelerated hyperfractionated radiotherapy combined with chemotherapy(LCAF+CT)group received the induction chemotherapy for two cycles, followed by conventional fractionation radiotherapy to a dose of 36 Gy, then changed into accelerated hyperfractionated radiotherapy to a total dose of 60 ~ 66 Gy. The conventional fractionation radiotherapy combined with chemotherapy(CF+CT)group received the chemotherapy that it was similar to LCAF+CT group, and used the conventional fractionation radiotherapy to a total dose of 60 ~ 66 Gy. Results The 1-, 3- and 5-year survival rates were 82.3 %, 51.6 %, 38.2 % in the LCAF+CT group, and 73.8 %, 31.5 %, 18.6 % in the CF+CT group. The differences of 3- and 5-year survival rates were statistically significant (P 0.05). Conclusion Late-coures accelerated hyperfractionated radiotherapy combined with chemotherapy might improve the treatment efficacy of advanced esophageal cancer and lengthen the suvival time. The toxic and side effects of LCAF+CT group were more severe than those of CF+CT group, but they were well tolerable.
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Objective To compare the efficacy and side effect of radiotherapy and radiotherapy combined with chemotherapy for esophageal carcinoma. Methods 90 patients with esophageal carcinoma were randomly divided into tow groups: control group 45 patients and combined therapy group 45 patients. Radiotherapy was performed on the control group, radiotherapy combined with chemotherapy which consisted of Carboplatin, 5-Fluorouracil and Hydroxycamptothecine were carried out the combined group. The two groups were under the same technical conditions and radiation dose. Three radiation fields were performed on both two groups at 200 cGy each time. The total radiation dose were 6 400 ~ 6 800 cGy. Results The local tumor control rate of combined group were higher than control group markedly. The acute gastrointestinal tract reaction and myetlosuppression were more serious than the control group. However, the late radiation reaction were not significance between the two groups. The main late reaction were radiation esophageal stricture and lung fibrosis. Conclusion Radiotherapy combined with chemotherapy is able to enhance the local control rate, 1 year and 3 years survival rate for esophageal carcinoma, but the acute side effect also increased and the late reaction were not increased.