摘要
Abstract
Objective To investigate the therapeutic effect of three-dimensional conformal radiotherapy(3D-CRT)combined with 5-fluorouracil and platinum-based chemotherapy on local recurrence occurring after radical resection of esophageal squamous cell carcinoma(ESCC)and its impact on patient survival.Methods Retrospective analysis was conducted on 51 patients with locally recurrent tumors within 2-25 months after radical resection of ESCC treated with 3D-CRT(60 Gy,30 sessions)combined with 5-fluorouracil and platinum based chemotherapy.Progression free survival(PFS),overall survival(OS),incidence of adverse events were evaluated by univariate and multivariate analysis.Results The overall treatment remission rate was 74.51%(38/51),the complete response(CR)rate was 49.02%,the median PFS was 8.2 months.The median OS was 23.1 months and the 3 year median OS was 40.71%.The PFS in patients achieving CR was higher than that in non-CR patients,15.86%>4.73%;the 3 year PFS rate was 49.01%,higher than 4.23%in non-CR patients(P<0.05).The duration of the disease in patients with CR was longer than that in non-CR patients,with a 3 yearOS rate of 62.54%in CR patients,which is higher than the 20.36%in non CR patients(P<0.05).Grade 4 leukopenia,neutropenia,and thrombocytopenia were seen in 2 cases each(3.92%),grade 3 fatigue in 9 cases(17.65%),grade 3 leukopenia in 8 cases(15.69%),grade 3 neutropenia in 7 cases(13.73%),grade 3 anemia and nausea both in 4 cases(7.84%),grade 3 hyponatremia in 2 cases(3.92%),grade 3 thrombocytopenia,febrile neutropenia,hyperglycemia and pneumonia were present in 1 case(1.96%).In the results of univariate analysis,ECOG PS stage 0 and longest diameter of recurrent tumor<25 mm were significantly associated with OS(P<0.05).The results of multivariate analysis showed that the longest metastatic lymph node diameter<25 mm was an independent prognostic factor for OS.Conclusion The salvage treatment for local recurrence after ESCC radical surgery with 3D-CRT combined with 5-fluorouracil and platinum-based chemotherapy is effective and safe,and about 40%of patients could achieve long-term survival.关键词
三维适形放疗/食管鳞状细胞癌/局部复发/5-氟尿嘧啶/铂类Key words
three-dimensional conformal radiotherapy/esophageal squamous cell carcinoma/local recurrence/5-fluorouracil/platinum分类
临床医学
