首页|Endoscopic stenting and concurrent chemoradiotherapy for advanced esophageal cancer: A case-control study

Endoscopic stenting and concurrent chemoradiotherapy for advanced esophageal cancer: A case-control study

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AIM:To evaluate the role of endoscopic stenting with or without concurrent 3-dimensional conformal chemoradiotherapy (3D-CRT) in patients with inoperable esophageal cancer.METHODS:Advanced esophageal cancer patients indicated for esophagectomy received esophageal stents.A part of patients completed 3D-CRT after stenting.Efficacy was assessed by endoscopy and computed tomographic scan before and 4 wk after completion of the treatment.The median survival,3D-CRT toxicity and complications were compared between 3D-CRT and control groups.RESULTS:From 1999 to 2008,99 consecutive patients with T3/T4 disease and unsuitable for esophagectomy were placed with esophageal stents.Sixty-seven patients received 3D-CRT,while 36 patients treated with endoscopic stents alone were recruited as controls.After 3D-CRT treatment,the median tumor volume of 3D-CRT patients were reduced significantly from 43.7 ±10.2 cm3 to 28.8 ± 8.5 cm3 (P ＜ 0.05).The complete and partial response rate was 85.1％,and no response was 14.9％.After 3D-CRT,the incidence rate of T2 and T3 disease evident on CT scan increased to 78.4％ while T4 decreased from 66.7％ to 21.6％ (P ＜ 0.05).3D-CRT Karnofsky Performance Status improved in 3D-CRT patients compared with the control group (P =0.031).3D-CRT patients had a longer survival than the control group (251.7 d vs 91.1 d,P ＜ 0.05).And the median half-year survival rate in 3D-CRT group (91％) was higher than in the control group (50％,P ＜ 0.05).The most common toxicity was leukocytopenia in the 3D-CRT group (46.7％ vs 18.8％,P =0.008).The control group had a higher rate of restenosis than the 3D-CRT group (81.3％ vs 9.0％,P ＜ 0.05).The rate of nephrotoxicity was increased in 3D-CRT as compared with the control group (31.3％ vs 15.6％,P ＜ 0.05).CONCLUSION:3D-CRT can improve dysphagia in patients with inoperable esophageal carcinoma.3D-CRT combined with stenting results in better survival as compared with endoscopic stents used alone.

Esophageal CancerStentsChemoradiotherapyThree-dimensional imagingCase control study

Xiang-Jun Jiang、Ming-Quan Song、Yong-Ning Xin、Yu-Qiang Gao、Zi-Yu Niu、Zi-Bin Tian

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Department of Gastroenterology, Qingdao Municipal Hospital affiliated to Qingdao University, Qingdao 266011, Shandong Province, China

Qingdao Key Laboratory of Digestive Diseases, Qingdao Municipal Hospital, Qingdao 266011, Shandong Province, China

Department of Gastroenterology, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003, Shandong Province, China

2012

10.3748/wjg.v18.i12.1404

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(12)
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