PDF(Pubmed)
Abstract：
UNASSIGNED: The effectiveness of intensity-modulated proton therapy (IMPT) for esophageal cancer treated with definitive concurrent chemoradiation therapy remains inadequately explored. We investigated long-term outcomes and toxicity experienced by patients who received IMPT as part of definitive esophageal cancer treatment.
UNASSIGNED: We retrospectively identified and analyzed 34 patients with locally advanced esophageal cancer who received IMPT with concurrent chemotherapy as a definitive treatment regimen at The University of Texas MD Anderson Cancer Center from 2011 to 2021. The median IMPT dose was 50.4 GyRBE in 28 fractions; concurrent chemotherapy consisted of fluorouracil and/or taxane and/or platinum. Survival outcomes were determined by the Kaplan-Meier method, and toxicity was scored according to the Common Terminology Criteria for Adverse Events version 4.0.
UNASSIGNED: The median age of all patients was 71.5 years. Most patients had stage III (cT3 cM0) adenocarcinoma of the lower esophagus. At a median follow-up time of 39 months, the 5-year overall survival rate was 41.1%; progression-free survival, 34.6%; local regional recurrence-free survival, 78.1%; and distant metastasis-free survival, 65.0%. Common acute chemoradiation therapy-related toxicities included hematologic toxicity, esophagitis (and late-onset), fatigue, weight loss, and nausea (and late-onset); grade 3 toxicity rates were 26.0% for hematologic, 18.0% for esophagitis and 9.0% for nausea. No patient had grade ≥3 wt loss or radiation pneumonitis, and no patients had pulmonary fibrosis or esophageal fistula. No grade ≥4 events were observed except for hematologic toxicity (lymphopenia) in 2 patients.
UNASSIGNED: Long-term survival and toxicity were excellent after IMPT for locally advanced esophageal cancer treated definitively with concurrent chemoradiation therapy. When available, IMPT should be offered to such patients to minimize treatment-related cardiopulmonary toxicity without sacrificing outcomes.
UNASSIGNED: We retrospectively identified and analyzed 34 patients with locally advanced esophageal cancer who received IMPT with concurrent chemotherapy as a definitive treatment regimen at The University of Texas MD Anderson Cancer Center from 2011 to 2021. The median IMPT dose was 50.4 GyRBE in 28 fractions; concurrent chemotherapy consisted of fluorouracil and/or taxane and/or platinum. Survival outcomes were determined by the Kaplan-Meier method, and toxicity was scored according to the Common Terminology Criteria for Adverse Events version 4.0.
UNASSIGNED: The median age of all patients was 71.5 years. Most patients had stage III (cT3 cM0) adenocarcinoma of the lower esophagus. At a median follow-up time of 39 months, the 5-year overall survival rate was 41.1%; progression-free survival, 34.6%; local regional recurrence-free survival, 78.1%; and distant metastasis-free survival, 65.0%. Common acute chemoradiation therapy-related toxicities included hematologic toxicity, esophagitis (and late-onset), fatigue, weight loss, and nausea (and late-onset); grade 3 toxicity rates were 26.0% for hematologic, 18.0% for esophagitis and 9.0% for nausea. No patient had grade ≥3 wt loss or radiation pneumonitis, and no patients had pulmonary fibrosis or esophageal fistula. No grade ≥4 events were observed except for hematologic toxicity (lymphopenia) in 2 patients.
UNASSIGNED: Long-term survival and toxicity were excellent after IMPT for locally advanced esophageal cancer treated definitively with concurrent chemoradiation therapy. When available, IMPT should be offered to such patients to minimize treatment-related cardiopulmonary toxicity without sacrificing outcomes.
摘要：
■强度调节质子治疗（IMPT）对食管癌进行确定性同步放化疗治疗的有效性仍未充分探索。我们调查了接受IMPT作为确定性食管癌治疗的患者的长期结局和毒性。
我们回顾性分析了2011年至2021年在德克萨斯大学MD安德森癌症中心接受IMPT联合化疗作为确定治疗方案的34例局部晚期食管癌患者。在28个部分中，MPT的中位剂量为50.4GyRBE；同时化疗由氟尿嘧啶和/或紫杉烷和/或铂组成。生存结果由Kaplan-Meier方法确定，根据4.0版不良事件通用术语标准对毒性评分。
■所有患者的中位年龄为71.5岁。大多数患者患有食管下段III期（cT3cM0）腺癌。中位随访时间为39个月，5年总生存率为41.1%;无进展生存期,34.6%；局部区域无复发生存率，78.1%;无远处转移生存率,65.0%。常见的急性放化疗相关毒性包括血液学毒性，食管炎（和迟发性），疲劳,减肥,恶心（和迟发性）；血液学的3级毒性率为26.0％，18.0%为食管炎，9.0%为恶心。没有患者有≥3级体重减轻或放射性肺炎，无肺纤维化或食管瘘患者。2例患者中，除血液学毒性（淋巴细胞减少）外，未观察到≥4级事件。
■IMPT治疗局部晚期食道癌后长期生存和毒性良好，明确同步放化疗治疗。如果可用,应向此类患者提供IMPT，以最大程度地减少与治疗相关的心肺毒性，而不牺牲结果。
我们回顾性分析了2011年至2021年在德克萨斯大学MD安德森癌症中心接受IMPT联合化疗作为确定治疗方案的34例局部晚期食管癌患者。在28个部分中，MPT的中位剂量为50.4GyRBE；同时化疗由氟尿嘧啶和/或紫杉烷和/或铂组成。生存结果由Kaplan-Meier方法确定，根据4.0版不良事件通用术语标准对毒性评分。
■所有患者的中位年龄为71.5岁。大多数患者患有食管下段III期（cT3cM0）腺癌。中位随访时间为39个月，5年总生存率为41.1%;无进展生存期,34.6%；局部区域无复发生存率，78.1%;无远处转移生存率,65.0%。常见的急性放化疗相关毒性包括血液学毒性，食管炎（和迟发性），疲劳,减肥,恶心（和迟发性）；血液学的3级毒性率为26.0％，18.0%为食管炎，9.0%为恶心。没有患者有≥3级体重减轻或放射性肺炎，无肺纤维化或食管瘘患者。2例患者中，除血液学毒性（淋巴细胞减少）外，未观察到≥4级事件。
■IMPT治疗局部晚期食道癌后长期生存和毒性良好，明确同步放化疗治疗。如果可用,应向此类患者提供IMPT，以最大程度地减少与治疗相关的心肺毒性，而不牺牲结果。
