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Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma

BACKGROUND: Since there is high local failure and poor survival for unresectable esophageal squamous cell carcinoma (ESCC), the necessity of elective node irradiation is controversial. The purpose of this study was to investigate the failure patterns and survival in patients with locally advanced ES...

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Autores principales: Zhang, Xiaoli, Li, Minghuan, Meng, Xue, Kong, Li, Zhang, Yan, Wei, Guangsheng, Zhang, Xiqin, Shi, Fang, Hu, Man, Zhang, Guoli, Yu, Jinming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942777/
https://www.ncbi.nlm.nih.gov/pubmed/24571804
http://dx.doi.org/10.1186/1748-717X-9-64
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author Zhang, Xiaoli
Li, Minghuan
Meng, Xue
Kong, Li
Zhang, Yan
Wei, Guangsheng
Zhang, Xiqin
Shi, Fang
Hu, Man
Zhang, Guoli
Yu, Jinming
author_facet Zhang, Xiaoli
Li, Minghuan
Meng, Xue
Kong, Li
Zhang, Yan
Wei, Guangsheng
Zhang, Xiqin
Shi, Fang
Hu, Man
Zhang, Guoli
Yu, Jinming
author_sort Zhang, Xiaoli
collection PubMed
description BACKGROUND: Since there is high local failure and poor survival for unresectable esophageal squamous cell carcinoma (ESCC), the necessity of elective node irradiation is controversial. The purpose of this study was to investigate the failure patterns and survival in patients with locally advanced ESCC receiving involved-field irradiation (IFI). METHODS: A retrospective study was preformed on the clinical records of patients with locally advanced ESCC, who have received IFI with concurrent chemotherapy between January 2003 and January 2009. Comparing the target volume and first sites of failure, patterns of failure were defined as in-field, out-of-field regional lymph node and distant failure. The survivals were analyzed by different patterns of failure. RESULTS: Eighty patients were included in our study. With a median follow-up of 52.6 months, failures were observed in 76 patients. In-field recurrence, distant metastasis, and out-of-field regional failure were seen in 53.75%, 41.25%, 30% patients, respectively. There were significant differences in OS for patients with and without in-field (median OS 14.2 vs.17.4 m, P = 0.01)or distant failure(13.2 vs.15.9 m, P ≤ 0.0001), but not for out-of-field regional lymph node failure(both 14.5 m, P = 0.665). CONCLUSIONS: The solitary regional nodal failure of out-of-field was acceptable in advanced ESCC patients treated with IFI. In-field and distant failures remained the predominant patterns and negatively impacted survival more significantly. Further investigation is needed to establish the optimal radiotherapy field for these patients at advanced stage.
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spelling pubmed-39427772014-03-06 Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma Zhang, Xiaoli Li, Minghuan Meng, Xue Kong, Li Zhang, Yan Wei, Guangsheng Zhang, Xiqin Shi, Fang Hu, Man Zhang, Guoli Yu, Jinming Radiat Oncol Research BACKGROUND: Since there is high local failure and poor survival for unresectable esophageal squamous cell carcinoma (ESCC), the necessity of elective node irradiation is controversial. The purpose of this study was to investigate the failure patterns and survival in patients with locally advanced ESCC receiving involved-field irradiation (IFI). METHODS: A retrospective study was preformed on the clinical records of patients with locally advanced ESCC, who have received IFI with concurrent chemotherapy between January 2003 and January 2009. Comparing the target volume and first sites of failure, patterns of failure were defined as in-field, out-of-field regional lymph node and distant failure. The survivals were analyzed by different patterns of failure. RESULTS: Eighty patients were included in our study. With a median follow-up of 52.6 months, failures were observed in 76 patients. In-field recurrence, distant metastasis, and out-of-field regional failure were seen in 53.75%, 41.25%, 30% patients, respectively. There were significant differences in OS for patients with and without in-field (median OS 14.2 vs.17.4 m, P = 0.01)or distant failure(13.2 vs.15.9 m, P ≤ 0.0001), but not for out-of-field regional lymph node failure(both 14.5 m, P = 0.665). CONCLUSIONS: The solitary regional nodal failure of out-of-field was acceptable in advanced ESCC patients treated with IFI. In-field and distant failures remained the predominant patterns and negatively impacted survival more significantly. Further investigation is needed to establish the optimal radiotherapy field for these patients at advanced stage. BioMed Central 2014-02-26 /pmc/articles/PMC3942777/ /pubmed/24571804 http://dx.doi.org/10.1186/1748-717X-9-64 Text en Copyright © 2014 Zhang et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Zhang, Xiaoli
Li, Minghuan
Meng, Xue
Kong, Li
Zhang, Yan
Wei, Guangsheng
Zhang, Xiqin
Shi, Fang
Hu, Man
Zhang, Guoli
Yu, Jinming
Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
title Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
title_full Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
title_fullStr Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
title_full_unstemmed Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
title_short Involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
title_sort involved-field irradiation in definitive chemoradiotherapy for locally advanced esophageal squamous cell carcinoma
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942777/
https://www.ncbi.nlm.nih.gov/pubmed/24571804
http://dx.doi.org/10.1186/1748-717X-9-64
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