PDF(Pubmed)
Abstract：
There are several reports of hepatic resection for postoperative hepatic metastatic recurrence of esophageal cancer. However, it is unclear whether surgery is the best local treatment for liver metastases. Thus, this study aimed to retrospectively analyze proton beam therapy (PBT) for postoperative liver metastatic recurrence of esophageal cancer without extrahepatic lesions and examine outcomes and adverse events. This single-center historical cohort study selected patients who underwent PBT at our proton therapy center between 2012 and 2018. The patients were selected based on the following criteria: primary esophagus carcinoma was resection and metachronous liver oligometastasis recurrence without extrahepatic tumors and no more than three liver metastases. This study included seven males with a median age of 66 (range, 58-78) years, and 15 lesions were included in the study. The median tumor size was 22.6 (7-55.3) mm. The most frequent dose was 72.6 Gy relative biological effect (RBE)/22 fractions (fr) for four lesions and 64 Gy (RBE)/8 fr for four lesions. The median survival time was 35.5 (13.2-119.4) months. The 1-, 2- and 3-year overall survival (OS) rates were 100%, 57.1% and 42.9%, respectively. The median progression-free survival (PFS) time was 8.7 (1.2-44.1) months. The 1-, 2- and 3-year PFS rates were 28.6%. The 1-, 2- and 3-year local control (LC) rates were 100%. No grade ≥4 radiation-induced adverse events (AEs) were observed. We conclude that PBT can be considered an alternative to hepatic resection for recurrent liver metastases postoperative esophageal cancer.
摘要：
关于食管癌术后肝转移复发的肝切除术有一些报道。然而,目前尚不清楚手术是否是肝转移的最佳局部治疗方法.因此，本研究旨在回顾性分析质子束治疗(PBT)对无肝外病变的食管癌术后肝转移复发的疗效及不良事件.这项单中心历史队列研究选择了2012年至2018年在我们的质子治疗中心接受PBT的患者。根据以下标准选择患者：原发性食管癌切除，异时性肝寡转移复发，无肝外肿瘤，肝转移不超过三个。这项研究包括7名男性，平均年龄为66岁(范围，58-78）年，研究中包括15个病变。中位肿瘤大小为22.6(7-55.3)mm。四个病变的最常见剂量为72.6Gy相对生物学效应（RBE）/22分数（fr），四个病变的最常见剂量为64Gy（RBE）/8fr。中位生存时间为35.5(13.2～119.4)个月。1-,2年和3年总生存率（OS）为100％，57.1%和42.9%，分别。中位无进展生存期（PFS）为8.7（1.2-44.1）个月。1-,2年和3年PFS率为28.6%。1-,2年和3年局部控制率（LC）为100％。未观察到≥4级辐射诱导的不良事件（AE）。我们得出的结论是，PBT可以被认为是食管癌术后复发性肝转移的肝切除术的替代方法。
