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Concurrent chemoradiotherapyof different radiation doses and different irradiation fields for locally advanced thoracic esophageal squamous cell carcinoma: A randomized, multicenter, phase III clinical trial  期刊论文  

  • 编号：
    AACEA94470496EF644CD4B0815DD9E35
  • 作者：
    Zhang, Jian#[1,2]Li, Minghao#[2]Zhang, Kaixian#[3]Zheng, Anping#[4]Li, Guang(李光)#[5]Huang, Wei(黄伟)#[2]Chen, Shaoshui[6];Chen, Xiangming[7];Li, Xiaomin[8];Sheng, Yanxing[9];Sun, Xinchen(孙新臣)[10]Liu, Liping[11];Liu, Xiaowei[12];Li, Jie[8];Wang, Jun(王军)[13]Ge, Hong(葛红)[14]Ye, Shucheng[12];Pang, Qingsong(庞青松)[15]Zhang, Xianwen[16];Dai, Shengbin[17];Yu, Richard[18];Gu, Wendong(顾文栋)[19]Dai, Mingming[20];Siqin, Gaowa[21];Han, Yunwei(韩云炜)[22]Ge, Xiaolin(葛小林)[10]Yuan, Xin[23];Yang, Yongjing[24];Zhu, Haiwen[25];Pu, Juan[26];Dong, Lihua(董丽华)[27]Sun, Xiangdong(孙向东)[28]Zhou, Jundong(周俊东)[29]Mao, Weidong[30];Gao, Fei[31];Lin, Haiqun[32];Gong, Heyi[2];Zhou, Tao[2];Li, Zhenjiang[2];Li, Hongsheng[2];Wang, Zhongtang(王中堂)[2]Li, Baosheng(李宝生)*[2,33]
  • 语种：
    英文
  • 期刊：
    CANCER COMMUNICATIONS ISSN：2523-3548 2024 年 44 卷 10 期 (1173 - 1188) ; OCT
  • 收录：
     
  • 关键词：
    clinical trial concurrent chemoradiotherapy elective nodal radiation esophageal squamous cell carcinoma high dose radiation involved field radiation overall survival standard dose radiation
  • 摘要：

    BackgroundConcurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). However, the optimal radiotherapy regimen, particularly in terms of total dose and planned range of irradiation field, remains unclear. This phase III clinical trial aimed to compare the survival benefits between different radiation doses and different target fields.MethodsThis trial compared two aspects of radiation treatment, total dose and field, using a two-by-two factorial design. The high-dose (HD) group received 59.4 Gy radiation, and the standard-dose (SD) group received 50.4 Gy. The involved field irradiation (IFI) group and elective nodal irradiation (ENI) group adopted different irradiation ranges. The participants were assigned to one of the four groups (HD+ENI, HD+IFI, SD+ENI and SD+IFI). The primary endpoint was overall survival (OS), and the secondary endpoints included progression-free survival (PFS). The synergy indexwas used to measure the interaction effect between dose and field.ResultsThe interaction analysis did not reveal significant synergistic effects between the dose and irradiation field. In comparison to the target field, patients in IFI or ENI showed similar OS (hazard ratio [HR] = 0.99, 95% CI: 0.80-1.23, p = 0.930) and PFS (HR = 1.02, 95% CI: 0.82-1.25). The HD treatment did not show significantly prolonged OS compared with SD (HR = 0.90, 95% CI: 0.72-1.11, p = 0.318), but it suggested improved PFS (25.2 months to 18.0 months). Among the four groups, the HD+IFI group presented the best survival, while the SD+IFI group had the worst prognosis. No significant difference in the occurrence of severe adverse events was found in dose or field comparisons.ConclusionsIFI demonstrated similar treatment efficacy to ENI in CCRT of ESCC. The HD demonstrated improved PFS, but did not significantly improve OS. The dose escalation based on IFI (HD+IFI) showed better therapeutic efficacy than the current recommendation (SD+ENI) and is worth further validation.

  • 推荐引用方式
    GB/T 7714：
    Zhang Jian,Li Minghao,Zhang Kaixian, et al. Concurrent chemoradiotherapyof different radiation doses and different irradiation fields for locally advanced thoracic esophageal squamous cell carcinoma: A randomized, multicenter, phase III clinical trial [J].CANCER COMMUNICATIONS,2024,44(10):1173-1188.
  • APA：
    Zhang Jian,Li Minghao,Zhang Kaixian,Zheng Anping,&Li Baosheng.(2024).Concurrent chemoradiotherapyof different radiation doses and different irradiation fields for locally advanced thoracic esophageal squamous cell carcinoma: A randomized, multicenter, phase III clinical trial .CANCER COMMUNICATIONS,44(10):1173-1188.
  • MLA：
    Zhang Jian, et al. "Concurrent chemoradiotherapyof different radiation doses and different irradiation fields for locally advanced thoracic esophageal squamous cell carcinoma: A randomized, multicenter, phase III clinical trial" .CANCER COMMUNICATIONS 44,10(2024):1173-1188.
  • 入库时间：
    9/8/2024 3:49:57 PM
  • 更新时间：
    9/8/2024 3:49:57 PM
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