| Part Ⅰ Analysis of Prognostic Factors of advanced esophageal carcinoma underwent Intensity modulated radiotherapy or Conventional radiotherapy combined chemotherapyObjective To retrospectively analyze the prognostic factors of advanced esophageal carcinoma (EPC), who underwent concurrent chemoradiotherapy. and to evaluate the optimal treatment modality for advanced EPC.Methods A total of 200 advanced EPC patients between January 2008 and December 2011 were reviewed, all of them received concurrent chemoradiotherapy, either IMRT or CRT. Among them, there were 92 and 108 patients in the IMRT and CRT group, respectively. The chemotherapy scheme was Paclitaxel combine with different platinum drugs (cisplatin, nedaplatin,oxaliplatin or lobaplatin); the number of chemotherapy cycles were 2-4.Result Patients who received IMRT had a significant higher 3-year overall survival(OS) than that received CRT(63.6% vs 38.9%,x2=12.102, P=0.001)). Three-year OS differed no significantly betweezn different chemotherapy regimen. There were 44.6%,57.55%,52.5% and 52.5% for those received cisplatin,nedaplatin,oxaliplatin and lobaplatin, respectively(x2=2.756,P=0.431); patients received different cycles of chemotherapy had comparable treatment outcome, the overall survival were 44.1%,51.6% and 57.4% for those underwent 2,3 and 4 chemotherapy at 3 years, (x2=2.497,P=0.287). Univariate analysis indicated that lesion length on X-ray, M stage,6th edition UICC staging and radiotherapy methods were the potential predicting factors. After multivariate analysis, the significant prognostic factors shown were gender, lesion length on X-ray and radiotherapy methods.Conclusion The significant prognostic factors for advanced EPC with concurrent chemoradiotherapy mainly lesion length on X-ray and radiotherapy methods.Part Ⅱ Analysis of Prognostic Factors of IMRT combined with chemotherapy with different platinums plus paclitaxel in advanced esophageal carcinomaObjective To retrospectively analyze the prognostic impact of chemotherapy with different platinum plus paclitaxel to those patients with advanced esophageal carcinoma (EPC), who underwent IMRT, and to explore the optimal chemotherapy for advanced EPC.Methods A total of 242 advanced EPC patients between January 2008-May 2014 were reviewed, all of them treated with different platinums(cisplatin,nedaplatin,oxaliplatin or lobaplatin) plus paclitaxel chemotherapy combined with IMRT. The median cycles of chemotherapy was 3 cycles(2-7).Results The overall median survival time was 31.1 months, the 1,2,3-year survival rates were77.7%,55.2%and47.4%.The 3-year survival rates of cisplatin, oxaliplatin, lobaplatin, nedaplatin were 44.4%,29.0%,54.2% and 43.3%(x2= 6.500, P= 0.090); The 3-year survival rates of 2cycles,3cycles and^4cycles chemotherapy were 40.1%,49.5% and 49.6% (x 2=2.664,P=0.264); The 3 years survival rates of different grades of esophageal tumor volume GTV-T1,GTV-T2,GTV-T3 were 65.1%,51.7% and 35.1%(x2=23.957, P< 0.001);The 3-year survival rates of the maximum diameter of metastasis lymph node 0,<3 cm and≥3 cm,were 73.2%,43.8% and 15.4%(x2=39.767, P<0.001). Multivariate analysis showed that esophageal tumor volume and the maximum diameter of metastatic lymph nodes were independent prognostic factors. In terms of Ⅲ to Ⅳ grades of hrombocytopenia, Nedaplatin group was significantly lower than the other three groups (P<0.05), In terms of Ⅲ to Ⅳ grades of leukopenia, lobaplatint group was significantly higher than the other three groups (P<0.05).The others side effects between four groups had no significant difference (P >0.05).Conclusion Esophageal tumor volume and the maximum diameter of metastatic lymph nodes were the independent prognostic factor of patients with advanced esophageal cancer underwent IMRT combined paclitaxel plus platinum-based chemotherapy. Four different platinum-based chemotherapy regimens and different chemotherapy cycles had no significant difference in prognosis. |
PDF Full Text Request