关键词: 食管肿瘤, 癌, 鳞状细胞, 抗肿瘤联合化疗方案, 预后, 放射疗法, 调强适形, 同步整合加量

Abstract: Objective To investigate the long-term prognosis of simultaneous integrated intensity modulation (SIBIMRT) combined with selective lymph node irradiation (ENI) with or without chemotherapy for radical treatment of esophageal squamous cell carcinoma. Methods Data of 130 patients with esophageal squamous cell carcinoma who received radical radiotherapy were analyzed retrospectively, and the long-term survival, prognostic factors, treatment failure mode and adverse reactions were analyzed. Results The 1- , 3- and 5-year overall survival (OS) and progression-free survival (PFS) rates were 81.5%, 52.7%, 39.8% and 70.7%, 40.6%, 35.8%, respectively. The median OS stage and PFS stage were 36.37 months and 23.89 months, respectively. Multivariate Cox analysis showed that cT3, cN1, no chemotherapy and GTV-V＞37.0 cm3 were independent risk factors for OS, and cT3 was independent risk factors for PFS (P＜0.05). In all patients, 39 patients (30.0%) had local recurrence, 20 patients (15.4%) had distant metastasis, and 4 patients had both. Among the 35 patients with local regional recurrence, there were 32 cases of local esophageal lesion recurrence, 1 case of regional lymph node recurrence, and 2 cases of local esophageal combined regional lymph node recurrence. All patients had no grade≥4 related adverse reactions during and after treatment. There was no significant difference in the incidence of grade≥2 adverse reactions between patients with combined chemotherapy and patients without combined chemotherapy. Conclusion SIB-IMRT combined with ENI is safe and effective in the treatment of patients with esophageal squamous cell carcinoma. It is recommended to combine chemotherapy for patients with better general conditions.

Key words: esophageal neoplasms, carcinoma, squamous cell, antineoplastic combined chemotherapy protocols, prognosis, radiotherapy, intensity-modulated, simultaneous integrated boost