Regional hyperthermia combined with radiotherapy for esophageal squamous cell carcinoma with supraclavicular lymph node metastasis
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Sheng Liming1,2, Ji Yongling1,2, Wu Qiner3, Du Xianghui1,2
1Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
2Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, China
3Department of Hyperthermia, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China
Du Xianghui, email: [email protected]
Keywords: esophageal cancer, regional hyperthermia, radiotherapy, prognosis
Received: June 15, 2016 Accepted: November 24, 2016 Published: December 24, 2016
To assess the efficacy and toxicity of Intensity-modulated radiotherapy (IMRT) and hyperthermia for upper and middle thoracic esophageal squamous cell carcinoma (UMT-ESCC) with supraclavicular lymph node metastasis. A total of 50 patients with UMT-ESCC with supraclavicular lymph node metastasis were evaluated in this retrospective study. All patients received IMRT. Hyperthermia was delivered simultaneously with irradiation, in 45 minutes twice a week for 5-6 weeks. Hyperthermia included supraclavicular lymph node metastasis. Forty-four patients (88.0%) received concurrent chemoradiotherapy based on cisplatin regimens. The most common types of hematological toxicities were anemia (62.0%) and leukopenia (60.0%). Most of these events were grade 1-2 and transient. The 3-year progression-free survival (PFS) rate and overall survival (OS) rate were 34.9% and 42.5%, respectively. Cox regression revealed that tumor length and number of supraclavicular lymph node metastasis were two independent predictors of OS (tumor length: HR=3.65, p=0.008; nodal stage: HR=8.07, p=0.019). The IMRT combined with supraclavicular regional hyperthermia has low toxicity and well tolerated with excellent local control in UMT-ESCC with supraclavicular lymph node metastasis.
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