Comparable Clinical Outcome Using Small or Large Gross Tumor Volume-to-Clinical Target Volume Margin Expansion in Neoadjuvant Chemoradiotherapy for Esophageal Squamous Cell Carcinoma.

Autor: Lee TH; Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea., Kim HJ; Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.; Cancer Research Institute, College of Medicine, Seoul National University, Seoul, Republic of Korea.; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea., Kim BH; Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea., Kang CH; Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea., Keam B; Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea., Moon HJ; Department of Thoracic and Cardiovascular Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea., Seong YW; Department of Thoracic and Cardiovascular Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea., Kim S; Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Jazyk: angličtina
Zdroj: Journal of oncology [J Oncol] 2022 Jun 03; Vol. 2022, pp. 5635071. Date of Electronic Publication: 2022 Jun 03 (Print Publication: 2022).
DOI: 10.1155/2022/5635071
Abstrakt: The purpose of this study was to evaluate the feasibility of small primary gross tumor volume (GTV)-to-clinical target volume (CTV) margin expansion in neoadjuvant chemoradiation for esophageal squamous cell carcinoma. Medical records of 139 patients with locally advanced esophageal squamous cell carcinoma who underwent neoadjuvant chemoradiation and radical esophagectomy were retrospectively reviewed. Patients treated with longitudinal primary GTV-to-CTV margin expansion of 2 cm and no additional expansion of the CTV through the esophagus were classified into a small margin (SM) group (37 patients). The remaining 102 patients were classified as a large margin (LM) group. Patterns of recurrence including local and out-field regional recurrence rates were compared between the two groups. Clinical outcomes including rates of local control, regional control, failure-free survival, and overall survival were also compared. More patients in the SM group underwent paclitaxel + carboplatin, Mckeown esophagectomy, and intensity-modulated radiation therapy than in the LM group. With a median follow-up of 25.6 months, there was no significant difference in the crude rate of local recurrence (10.8% vs. 6.9%, P =0.694), out-field regional recurrence (27.0% vs. 19.6%, P =0.480), or out-field regional recurrence without in-field recurrence (10.8% vs. 12.7%, P =0.988) between the two groups. There was no significant difference in failure-free survival (5-year, 34.4% vs. 30.6%, P =0.652) or overall survival (44.1% vs. 38.5%, P =1.000), either. Esophageal fistula was not reported in the SM group (0.0% vs. 7.9%, P =0.176). In conclusion, a radiation field with 2 cm of longitudinal primary GTV-to-CTV was feasible in the neoadjuvant setting for esophageal squamous cell carcinoma treatment.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2022 Tae Hoon Lee et al.)
Databáze: MEDLINE
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