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1、一项回顾性研究对锎-252中子近距离放射治疗相结合EBRT与食管鳞状细胞癌的治疗疗效BackgroundWorldwide, an estimated 482,000 new esophageal cancer cases were diagnosed and approximately 407,000 deaths occurred in 2008 1. The management of localized esophageal cancers has shifted from surgery or radiation single modality approaches to the t
2、rimodality. The current trimodality approach combining chemotherapy, radiation therapy, and surgery, has shown improved survival rates* Correspondence: chris.wangnre.gatech.edu3Medical Physics Program, School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332-0745, USAFull
3、 list of author information is available at the end of the article2. However, there are patients that either cannot tolerate or decide not to undergo surgery. For these individuals, concurrent chemoradiotherapy (CCRT) is the standard approach.In recent years, two radiotherapy modalities have become
4、widely used in China to treat esophageal cancers: the neutron brachytherapy in combination with conventional external beam radiotherapy (NBT + EBRT) and the 3-dimensional conformal radiotherapy (3D-CRT). Currently there are no prospective, randomized trials comparing the efficacy of the two modaliti
5、es for the treatment of esopha-geal cancer. The choice between the two modalities is not 2015 Wang et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http:/creativecommons.org/licenses/by/4.0/), which permits unrestricted use
6、, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http:/creativecommons.org/publicdoma
7、in/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Wang et al. Radiation Oncology (2015) 10:212Page 2 of 8trivial, and their characteristics can have bearing on both disease control and adverse effects 3. Generally speaking, 3D-CRT tends to treat lymph nodes ad
8、jacent to the target with relatively high doses, whereas EBRT tends to cover farther regional nodes with lower doses 4, 5. Because the radiation dose of NBT is highly localized, the NBT + EBRT has a benefit of sculpting away high-dose regions from normal tissues, e.g. the heart and lungs. In additio
9、n to clinical considerations, there are also substantial differ-ences between NBT + EBRT and 3D-CRT (i.e. EBRT-only) in terms of the allocations of time, labor, and health care costs. Accordingly, we conducted a retrospective study on patients of esophageal squamous cell carcinoma (ESCC) who were tr
10、eated with either NBT + EBRT or 3D-CRT todetermine the differences in efficacy and morbidity of the two modalities.MethodsPatientsFrom January 2002 to November 2012, two groups of patients diagnosed with localized ESCC were treated separately at two different hospitals and with two different radioth
11、erapy modalities. The first group of 545 patients were treated at the Changzhi Cancer Hospital with NBT + EBRT, and the second group of 339 patients were treated at the Sichuan cancer hospital with 3D-CRT (i.e. EBRT-only). All 884 patients had histologically confirmed ESCC meas-uring 10 cm or less i
12、n length. The primary tumors of theTable 1 The characteristics of patients of the two treatment groups (EBRT + NBT and 3D-CRT) and the univariate analysis of the clinical outcomeCharacteristicsTotal (%)EBRT + NBT (%)3D-CRT (%)P value*5y OS (%)P value5y LC (%)P valueGender65458 (51.8)261 (47.9)197 (5
13、8.1)23.546.4Tumor length0.2200.00015 cm475 (53.7)284 (52.1)191 (56.3)22.942.4Tumor location0.00010.2330.581Upper329 (37.2)174 (31.9)155 (45.7)26.949.2Middle442 (50.0)309 (56.7)133 (39.2)27.845.6Lower113 (12.8)62 (11.4)51 (15.0)20.946.4T stage0.0060.00010.0001T132 (3.6)20 (3.7)12 (3.5)64.173.1T2163 (
14、18.4)107 (19.6)56 (16.5)32.951.7T3305 (34.5)164 (30.1)141 (41.6)31.253.9T4384 (43.4)254 (46.6)130 (38.3)17.637.7N stage0.00010.0001N0461 (52.1)338 (62.0)123 (36.3)32.653.2N1423 (47.9)207 (38.0)216 (63.7)20.240.0AJCC stage0.00010.00010.0001I28 (3.2)20(3.7)8 (2.4)72.374.5IIa280 (31.7)195 (35.8)85 (25.1)36.
