Endoscopic debulking resection with additive chemoradiotherapy:Optimal management of advanced inoperable esophageal squamous cell carcinoma  

作　　者：Li-Hua Ren Ye Zhu Rong Chen Mulmi Shrestha Sachin Qin Lu Wei-Hua Xie Tong Lu Xiao-Ying Wei Rui-Hua Shi 

机构地区：[1]Department of Gastroenterology,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,Jiangsu Province,China [2]Department of Oncology,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,Jiangsu Province,China [3]Department of Gastroenterology,Affiliated Zhongda Hospital of Southeast University,Nanjing 210009,Jiangsu Province,China [4]Quality Management,The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325000,Zhejiang Province,China [5]Department of Radiology,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu Province,China [6]Department of Pathology,Zhongda Hospital,Southeast University,Nanjing 210009,Jiangsu Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2022年第9期1758-1770,共13页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by Fundamental Research Funds for the Central Universities;Postgraduate Research and Practice Innovation Program of Jiangsu Province,No. KYCX19_0118;Jiangsu Science and Technology Project;Innovative Team Project of Esophagus,No. 2017ZXK7QW08;National Natural Science Foundation of China,No. 81570503。

摘　　要：BACKGROUND There is no remedial strategy other than definitive chemoradiotherapy for patients with advanced esophageal squamous cell carcinoma(ESCC) who are not eligible to undergo surgical treatment.AIM To introduce a novel therapy called endoscopic debulking resection(Ed R) followed by additive chemoradiotherapy(CRT) and evaluate its efficacy and safety.METHODS Advanced, inoperable ESCC patients between 1 January 2015 and 30 December 2019 were investigated retrospectively. Patients who received Ed R followed by CRT were deemed the Ed R + CRT group and those without CRT were deemed the Ed R group. Overall survival(OS), progression-free survival(PFS), and adverse events were evaluated.RESULTS A total of 41 patients were enrolled. At a median follow-up of 36 mo(range: 1-83), the estimated 1-, 2-, and 3-year cumulative OS rates of patients who underwent Ed R plus additive CRT were 92.6%, 85.2%, and 79.5%, respectively, which were higher than those of patients who underwent Ed R alone(1-year OS, 83.3%;2-year OS, 58.3%;3-year OS, 50%;P = 0.05). The estimated 2-year cumulative PFS rate after Ed R + CRT was 85.7%, while it was 61.5% after Ed R(P = 0.043). According to the univariate and multivariate Cox regression analyses, early clinical stage(stage ≤ IIB) and additive CRT were potential protective factors for cumulative OS. No severe adverse events were observed during the Ed R procedure, and only mild to moderate myelosuppression and radiation pneumonia were observed in patients who underwent additive CRT after Ed R.CONCLUSION Ed R plus CRT is an alternative strategy for selective advanced inoperable ESCC patients.

关 键 词：Esophageal squamous cell carcinoma Endoscopic resection CHEMORADIOTHERAPY Overall survival Progression-free survival 

分 类 号：R735.1[医药卫生—肿瘤]