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Efficacy and Prognostic Analysis of 315 Stage I–IVa Esophageal Cancer Patients Treated with Simultaneous Integrated Boost-Intensity-Modulated Radiation Therapy
Cancer Management and Research ( IF 3.3 ) Pub Date : 2021-09-07 , DOI: 10.2147/cmar.s329625 Peng Cai 1 , Yan Yang 1 , Duo-Jie Li 1
Cancer Management and Research ( IF 3.3 ) Pub Date : 2021-09-07 , DOI: 10.2147/cmar.s329625 Peng Cai 1 , Yan Yang 1 , Duo-Jie Li 1
Affiliation
Purpose: Use of simulated integrated boost-intensity-modulated radiation therapy (SIB-IMRT) is rarely reported in the treatment of esophageal cancer. This study was performed to observe the curative effect and prognostic factors associated with concurrent chemoradiotherapy for esophageal cancer using modern radiotherapy (RT) techniques.
Patients and Methods: In total, 315 patients with esophageal squamous cell carcinoma who received SIB-IMRT between 2015 and 2018 were included in this retrospective study. Median doses were planning target volume (PTV) 5400 cGy, 30 times (180cGy/fraction); planning gross tumor volume (PGTV) 6000 cGy, 30 times (200 cGy/fraction), once a day and 5 times a week. The entire period of RT was 6 weeks. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse reactions were observed. Univariate analysis was performed, and factors with P< 0.15 were included in multivariate analysis. Cox regression analysis was used for multivariate prognostic analysis. P< 0.05 was considered statistically significant. The incidence of adverse reactions under single chemotherapy concurrent chemoradiotherapy (sCCRT) and double chemotherapy concurrent chemoradiotherapy (dCCRT) was analyzed.
Results: Two-year, 3-year OS and PFS of the entire group were 49.5%, 40.2% and 40.3%, 34.0%, and the median survival time was 23.5 months. Univariate and multivariate analyses showed that T-stage (P=0.049), N-stage (P=0.024), clinical stage (P=0.041), short-term efficacy (P< 0.001), and use of concurrent chemotherapy (P< 0.001) were the influencing factors for OS. ORR was 87.6%. Adverse reactions were significantly increased with increasing chemotherapy dose.
Conclusion: The adverse reactions of SIB-IMRT in esophageal cancer can be tolerated. T-stage, N-stage, clinical stage, short-term curative effect, and concurrent chemotherapy are the prognostic factors affecting survival. Because it has lower toxicity and is as effective as dCCRT, sCCRT should be considered in the management of esophageal cancer.
Keywords: esophageal neoplasm, prognosis, intensity-modulated radiotherapy, SIB-IMRT
中文翻译:
315 例 I-IVa 期食管癌患者接受同步增强调强放疗的疗效和预后分析
目的:在食管癌治疗中很少报道使用模拟综合增强调强放射治疗(SIB-IMRT)。本研究旨在观察现代放射治疗(RT)技术对食管癌同步放化疗的疗效和预后因素。
患者和方法:该回顾性研究共纳入 2015 年至 2018 年间接受 SIB-IMRT 的 315 名食管鳞状细胞癌患者。中位剂量为计划靶区(PTV)5400 cGy,30次(180cGy/fraction);计划总肿瘤体积 (PGTV) 6000 cGy,30 次(200 cGy/分次),每天一次,每周 5 次。整个 RT 期为 6 周。观察总生存期(OS)、无进展生存期(PFS)、客观缓解率(ORR)和不良反应。进行单因素分析,将P<0.15的因素纳入多因素分析。Cox回归分析用于多变量预后分析。P < 0.05被认为具有统计学意义。
结果:全组2年、3年OS和PFS分别为49.5%、40.2%和40.3%、34.0%,中位生存时间为23.5个月。单因素和多因素分析显示,T分期(P=0.049)、N分期(P=0.024)、临床分期(P=0.041)、近期疗效(P<0.001)、使用同步化疗(P< 0.001) 是影响 OS 的因素。ORR 为 87.6%。随着化疗剂量的增加,不良反应显着增加。
结论:SIB-IMRT在食管癌中的不良反应是可以耐受的。T分期、N分期、临床分期、近期疗效、同步化疗是影响生存的预后因素。因为它具有较低的毒性并且与 dCCRT 一样有效,所以在食管癌的治疗中应考虑 sCCRT。
关键词:食管肿瘤,预后,调强放疗,SIB-IMRT
更新日期:2021-09-06
Patients and Methods: In total, 315 patients with esophageal squamous cell carcinoma who received SIB-IMRT between 2015 and 2018 were included in this retrospective study. Median doses were planning target volume (PTV) 5400 cGy, 30 times (180cGy/fraction); planning gross tumor volume (PGTV) 6000 cGy, 30 times (200 cGy/fraction), once a day and 5 times a week. The entire period of RT was 6 weeks. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and adverse reactions were observed. Univariate analysis was performed, and factors with P< 0.15 were included in multivariate analysis. Cox regression analysis was used for multivariate prognostic analysis. P< 0.05 was considered statistically significant. The incidence of adverse reactions under single chemotherapy concurrent chemoradiotherapy (sCCRT) and double chemotherapy concurrent chemoradiotherapy (dCCRT) was analyzed.
Results: Two-year, 3-year OS and PFS of the entire group were 49.5%, 40.2% and 40.3%, 34.0%, and the median survival time was 23.5 months. Univariate and multivariate analyses showed that T-stage (P=0.049), N-stage (P=0.024), clinical stage (P=0.041), short-term efficacy (P< 0.001), and use of concurrent chemotherapy (P< 0.001) were the influencing factors for OS. ORR was 87.6%. Adverse reactions were significantly increased with increasing chemotherapy dose.
Conclusion: The adverse reactions of SIB-IMRT in esophageal cancer can be tolerated. T-stage, N-stage, clinical stage, short-term curative effect, and concurrent chemotherapy are the prognostic factors affecting survival. Because it has lower toxicity and is as effective as dCCRT, sCCRT should be considered in the management of esophageal cancer.
Keywords: esophageal neoplasm, prognosis, intensity-modulated radiotherapy, SIB-IMRT
中文翻译:
315 例 I-IVa 期食管癌患者接受同步增强调强放疗的疗效和预后分析
目的:在食管癌治疗中很少报道使用模拟综合增强调强放射治疗(SIB-IMRT)。本研究旨在观察现代放射治疗(RT)技术对食管癌同步放化疗的疗效和预后因素。
患者和方法:该回顾性研究共纳入 2015 年至 2018 年间接受 SIB-IMRT 的 315 名食管鳞状细胞癌患者。中位剂量为计划靶区(PTV)5400 cGy,30次(180cGy/fraction);计划总肿瘤体积 (PGTV) 6000 cGy,30 次(200 cGy/分次),每天一次,每周 5 次。整个 RT 期为 6 周。观察总生存期(OS)、无进展生存期(PFS)、客观缓解率(ORR)和不良反应。进行单因素分析,将P<0.15的因素纳入多因素分析。Cox回归分析用于多变量预后分析。P < 0.05被认为具有统计学意义。
结果:全组2年、3年OS和PFS分别为49.5%、40.2%和40.3%、34.0%,中位生存时间为23.5个月。单因素和多因素分析显示,T分期(P=0.049)、N分期(P=0.024)、临床分期(P=0.041)、近期疗效(P<0.001)、使用同步化疗(P< 0.001) 是影响 OS 的因素。ORR 为 87.6%。随着化疗剂量的增加,不良反应显着增加。
结论:SIB-IMRT在食管癌中的不良反应是可以耐受的。T分期、N分期、临床分期、近期疗效、同步化疗是影响生存的预后因素。因为它具有较低的毒性并且与 dCCRT 一样有效,所以在食管癌的治疗中应考虑 sCCRT。
关键词:食管肿瘤,预后,调强放疗,SIB-IMRT