Stricture rate after chemoradiotherapy and radiotherapy for oesophageal squamous cell carcinoma: a 20-year experience.

Autor: Hamer PW; Department of Surgery, Christchurch Hospital, Christchurch, New Zealand., Hight SC; Department of Surgery, Christchurch Hospital, Christchurch, New Zealand., Ward IG; Canterbury Regional Cancer and Haematology Service, Christchurch Hospital, Christchurch, New Zealand., Harris DL; Canterbury Regional Cancer and Haematology Service, Christchurch Hospital, Christchurch, New Zealand., Woodham BL; Department of Surgery, Christchurch Hospital, Christchurch, New Zealand., Flint RS; Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.; University of Otago, Dunedin, New Zealand.
Jazyk: angličtina
Zdroj: ANZ journal of surgery [ANZ J Surg] 2019 Apr; Vol. 89 (4), pp. 367-371. Date of Electronic Publication: 2019 Feb 21.
DOI: 10.1111/ans.14981
Abstrakt: Background: Definitive chemoradiation for oesophageal squamous cell carcinoma (SCC) is the first-line treatment in many centres. However, it is not without morbidity. We assess outcomes for patients treated with definitive chemoradiotherapy and radiotherapy.
Methods: A retrospective review of a prospectively maintained database (Radiotherapy Department, Canterbury District Health Board) was undertaken. All patients who underwent definitive radiotherapy for oesophageal SCC between October 1996 and April 2015 were included.
Results: Sixty patients underwent chemoradiotherapy with curative intent and 17 underwent definitive radiotherapy with curative intent. Median age was 69 years (44-84 years) for those undergoing chemoradiotherapy and 73 years (36-85 years) for those who underwent definitive radiotherapy. Tumour location in all patients was upper third in 14 (18%), middle third in 39 (51%), lower third in 22 (29%) cases and junctional tumour in two (3%). Staging information was complete for 73 of 77 patients (stage I 16/77 (21%), stage II 40/77 (52%), stage III 17/77 (22%)). Median dose of external beam radiotherapy for those who underwent definitive chemotherapy was 50.4 Gy (30-63 Gy) and 60 Gy (50-64 Gy) for definitive radiotherapy. Median length of follow-up was 39 months (range 4-120 months). Strictures developed in 58% of all patients (52% chemoradiotherapy and 76% definitive radiotherapy). Twenty-four (32%) patients were dilated and 14 (18%) stented. The chemoradiotherapy group had higher 5-year survival than definitive radiotherapy group (34% versus 6%, P = 0.0034).
Conclusion: Oesophageal SCC treated with chemoradiation has a 5-year survival rate of 34%. Post-treatment strictures occur in 52% of patients with chemoradiotherapy and 76% with definitive radiotherapy.
(© 2019 Royal Australasian College of Surgeons.)
Databáze: MEDLINE
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