| 摘要 |
Objective: To investigate the role of postoperative chemoradiotherapy in locally
advanced esophageal cancer after primary surgery.
Methods: Forty-one patients with locally advanced esophageal cancer (30/41 pathologic Stage IIIA-C, 73.2%) who underwent radical surgery and complete postoperative chemoradiotherapy between May 2004 and May 2010 were enrolled. The radiotherapy was delivered by the intensity-modulated radiotherapy technique. Concurrently, chemotherapy with cisplatin and 5-fluorouracil was given on the 1st week and the 5th week of radiotherapy. The overall survival,
disease-free survival, and local recurrence rate were calculated to determine the role of postoperative radiotherapy in locally advanced esophageal cancer. Univariate analysis was used to elucidate the prognostic risk factors.
Results: After a median follow-up of 34.5 months (range, 3-87 months), the median overall survival was 13 months. The 1-year and 3-year overall survival rates were 61.0 % and 24.6%, respectively. The disease free survival after 1 year and 3 year was 42.8% and 28.1%, respectively. There was a significant difference in survival between the patients who had N0/1 and N2/3 disease by univariate analysis with 1-year survival and median survival rates of 66.7%
versus 37.5% and 17 months versus 10.5 months, respectively (pZ0.036). The local recurrence rate was 17.1 % (7/41) at 3 years. Acute treatment-related toxicities were mild. Most of the patients died of distant metastasis.
Conclusion: Postoperative chemoradiotherapy showed a mild acute treatment-related toxicity and a relatively good local control but these effects did not contribute a higher survival rate to patients with advanced esophageal cancer. |
