Outcomes of definitive carbon-ion radiotherapy for cT1bN0M0 esophageal squamous cell carcinoma.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Esophagus Pub Date : 2024-10-01 Epub Date: 2024-05-30 DOI:10.1007/s10388-024-01067-7

Tetsuro Isozaki, Hitoshi Ishikawa, Shigeru Yamada, Yoshihiro Nabeya, Keiko Minashi, Kentaro Murakami, Hisahiro Matsubara

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Abstract

Background: A recent phase I/II study determined the optimal dose of definitive carbon-ion radiotherapy (CIRT) for cT1bN0M0 esophageal cancer. This study aimed to further confirm the efficacy and feasibility of the recommended dose fractionation of CIRT with long-term follow-up results in a larger sample size.

Methods: This single center retrospective study evaluated patients with cT1bN0M0 esophageal squamous cell carcinoma treated with the recommended dose fractionation of 50.4 Gy relative biological effectiveness in 12 fractions, between 2012 and 2022.

Results: Thirty-eight patients underwent CIRT at our hospital. Although eight (21.1%) patients were older than 80 years, 15 (39.5%) had high surgical risk, and seven (18.4%) were at high risk for chemotherapy, all patients underwent CIRT as scheduled. Grade 3 esophagitis occurred in eight (21.1%) patients and grade 3 pneumonia in one (2.6%) patient in this study, but no grade 4 adverse events occurred. The only grade 3 late adverse event was pneumonia in one patient (2.6%). The 5-year overall survival rate, local control rate, and disease-free survival rates were 76.6% (95% CI, 90.9-62.4), 74.9% (95% CI, 90.7-59.0), and 66.4% (95% CI, 83.3-49.5), respectively. Additionally, post CIRT recurrence was as follows: seven (18.4%) patients had recurrence in another part of the esophagus, three (7.9%) in the primary site, three (7.9%) in lymph nodes outside the irradiated area, and one (2.6%) patient had liver metastasis.

Conclusions: Our study demonstrates that CIRT using the recommended dose fractionation is feasible and effective for cT1bN0M0 esophageal squamous cell carcinoma.

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cT1bN0M0食管鳞状细胞癌的最终碳离子放射治疗效果。

背景：最近的一项I/II期研究确定了cT1bN0M0食管癌确定性碳离子放疗（CIRT）的最佳剂量。本研究旨在通过更大样本量的长期随访结果，进一步证实碳离子放疗推荐剂量分次的有效性和可行性：这项单中心回顾性研究评估了2012年至2022年间接受推荐剂量分次治疗的cT1bN0M0食管鳞状细胞癌患者，推荐剂量分次为50.4 Gy，相对生物效应为12次：我院有 38 名患者接受了 CIRT 治疗。虽然有 8 名（21.1%）患者年龄超过 80 岁，15 名（39.5%）患者手术风险高，7 名（18.4%）患者化疗风险高，但所有患者都按计划接受了 CIRT 治疗。在这项研究中，8 名患者（21.1%）发生了 3 级食管炎，1 名患者（2.6%）发生了 3 级肺炎，但没有发生 4 级不良事件。唯一的 3 级晚期不良事件是一名患者（2.6%）的肺炎。5年总生存率、局部控制率和无病生存率分别为76.6%（95% CI，90.9-62.4）、74.9%（95% CI，90.7-59.0）和66.4%（95% CI，83.3-49.5）。此外，CIRT术后复发情况如下：7例（18.4%）患者在食管其他部位复发，3例（7.9%）在原发部位复发，3例（7.9%）在照射区域外的淋巴结复发，1例（2.6%）患者出现肝转移：我们的研究表明，采用推荐剂量分次进行 CIRT 治疗 cT1bN0M0 食管鳞癌是可行且有效的。

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来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.