Accelerated fractionation in esophageal cancers: A multivariate analysis on 88 patients

作     者：Girinsky, T Auperin, A Marsiglia, H Dhermain, F Randrianarivelo, H Kac, J Ducreux, M Elias, D Rougier, P 

作者机构：INST GUSTAVE ROUSSYDEPT MED ONCOLF-94805 VILLEJUIFFRANCE INST GUSTAVE ROUSSYDEPT SURG ONCOLF-94805 VILLEJUIFFRANCE INST GUSTAVE ROUSSYDEPT BIOSTAT & EPIDEMIOLF-94805 VILLEJUIFFRANCE 

出 版 物：《INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS》 (国际放射肿瘤学-生物学-物理学杂志)

年 卷 期：1997年第38卷第5期

页      面：1013-1018页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 1009[医学-特种医学] 10[医学] 

主　　题：esophageal cancer overall treatment time accelerated fractionation neoadjuvant chemotherapy radiotherapy 

摘      要：Purpose: Accelerated fractionation was used to shorten overall treatment time to increase locoregional control and cause-specific survival. Methods and Materials: Eighty-eight patients with cancer of the esophagus ineligible for surgery mere entered in the study between 1986 and 1993. Neoadjuvant chemotherapy was given to 64% of patients. Accelerated radiotherapy using the concomitant boost technique delivered a median dose of 65 Gy in a median overall treatment time of 32 days. Results: The 3-year actuarial local control rate in patients with TI, T2, and T3 tumors was 71%, 42%, and 33%, respectively, The 3-year cause-specific survival rates were 40%, 22%, and 6%, respectively. Sixteen percent of patients experienced Grade 3 esophagitis. Late toxicity included esophageal stenosis and pulmonary fibrosis in 8% and 9% of the patients, respectively. Multivariate analysis demonstrated that T stage and overall treatment time were prognostic factors for cause-specific survival. T stage and neoadjuvant chemotherapy mere independent prognostic factors for locoregional control, Conclusion: These findings suggest that accelerated fractionation given in an overall treatment time of 35 days might be beneficial for early-stage cancer of the esophagus, Neodajuvant chemotherapy is not recommended, as it was a significant adverse prognostic factor in the multivariate analysis for local control. Accelerated fractionation can be carried out with moderate acute and late toxicity. (C) 1997 Elsevier Science Inc.