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자료유형
학술저널
저자정보
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제45권 제4호
발행연도
2013.1
수록면
276 - 284 (9page)

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Purpose Locally advanced esophageal cancers are generally treated with neoadjuvant chemoradiotherapy, followed by surgery in operable candidates. However, even if the patients were diagnosed as operable disease, surgery could not be performed on patients with poor condition or other comorbidity. In this case, definitive chemoradiotherapy (dCRT) is the other option for localized esophageal cancer. Therefore, the purpose of this study was to evaluate the efficacy and clinical prognostic factors for dCRT in locally advanced esophageal cancer. Materials and Methods We conducted a review of patients who received dCRT for locally advanced squamous esophageal cancer from 2004 to 2010, focusing on stages III and IVa. All patients received at least two cycles of platinum-based chemotherapy during radiation, and all tumor burdens were included in the radiation field. The treatment results were analyzed for patterns of failure and prognostic factors associated with survival. Results In total, 63 patients were enrolled in this study. The overall response rate was 84.1%. Relief from dysphagia after dCRT was achieved in 48 patients. The most frequent failure was local recurrence. The median overall survival (OS) was 23.0 months, and the 2-year survival rate was 45.4%. Similar results were observed for elderly study patients. Significant prognostic factors for OS were duration of smoking, high grade of dysphagia (score of 3 or 4), and shorter duration of progression-free and dysphagia-free survival. Maintenance chemotherapy after dCRT did not influence OS. However, “good risk” patients receiving maintenance chemotherapy showed better OS than those who did not receive maintenance chemotherapy (30.4 months vs. 12.0months, p=0.002). Conclusion dCRT has a major role in improving survival and palliation of dysphagia in inoperable advanced esophageal cancer, even in elderly patients. Maintenance chemotherapy after dCRT may be effective in prolonging survival in “good risk” patients.
#Esophageal squamous cell carcinoma #Chemoradiotherapy #Prognosis

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참고문헌 (22)

참고문헌 신청
Cooper JS / 1999 / Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Gro google schola Crosby TD / 2004 / Definitive chemoradiation in patients with inoperable oesophageal carcinoma / Br J Cancer 90 : 70 ~ 75 google schola Di Fiore F / 2006 / Predictive factors of survival in patients treated with definitive chemoradiotherapy for squamous cell esophageal carcinoma / World J Gastroenterol 12 : google schola Enzinger PC / 2003 / Esophageal cancer / N Engl J Med 349 : 2241 ~ 2252 google schola Green FL / 2002 / AJCC cancer staging handbook: from the AJCC cancer staging manual / Springe google schola

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