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開催概要
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第51回・2013年・京都
 

Chemoradiotherapy using IMRT for Locally Advanced Esophageal Cancer

演題番号 : O94-3

[筆頭演者]
Hayato Omori:1 
[共同演者]
Masato Nakamura:2、Keita Oda:3、Yusuke Takahashi:1、Ryosuke Hirano:1、Makoto Komatsu:1、Kotaro Sasahara:1、Hirofumi Kishimoto:1、Katsunori Tauchi:1

1:department of surgery, Aizawa Hospital, Japan、2:department of chemotherapy,Aizawa Comprehensive Cancer Center, Japan、3:department of radiation therapy, Japan

 

Background:For locally advanced esophageal cancer, chemoradiotherapy is recommended. Historically, radiation to the esophagus was delivered with 2D techniques that affected a large volume of normal tissue. This irradiation of normal tissue causes acute and late toxicity. With intensity-modulated radiotherapy (IMRT), there is not one individual beam of uniform dose but rather a series of individual beamlets each programmed to vary the dose intensity across the target/normal tissue interface. IMRT enables the intended dose to be shaped three-dimensionally to maximize the dose to the intended target and minimize the dose to the healthy tissue. We evaluated the clinical efficacy and safety of IMRT for locally advanced esophageal cancer retrospectively.Methods: Between May 2008 and December 2012, 23 locally advanced esophageal cancer patients were treated with IMRT+chemotherapy. The treatment consisted of chemotherapy (5-FU and cisplatin; FP) and concurrent irradiation using IMRT of 50-60 Gy in 25-30 fractions to the esophageal primary tumor and regional lymph nodes. Clinically, 22 patients had dysphagia due to primary tumor.Results: The overall response rate of the primary lesion was 96.5%, including 13 CR patients (56.5%). Dysphagea was improved in 19 patients (86.4%). The median overall survival was 13.8 months, and the 1-year and 3-year survival rate were 50.0% and 36.3% respectively. The median progression-free survival was 6.5 months. Recurrences were observed in 18 patients and recurrent sites were distant metastasis, with only 1 patient having local recurrence.Major severe adverse events were leucocytopenia (34.8%) and neutrocytopenia (17.4%). No patient died within the treatment schedule or for 30 days after treatment.Conclusions: IMRT+FP for inoperable locally advanced esophageal cancer showed a very high local control rate and improved dysphagea. Distant metastases were the main cause of death and adjuvant treatment will be needed to prevent them.

キーワード

臓器別:食道

手法別:集学的治療

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