The Analysis Of Re-treatment Pattern Of Local Regional Failure For Esophageal Carcinoma After Definitive Radiotherapy

Objective: The aim of this study was to observe the prognostic effect factors which accepted different re-treatment pattern for patients of esophageal carcinoma who suffered from local regional recurrence or lymphatic metastasis,and in order to provide a reference for evaluating the prognosis and selected the individualized therapeutic program.Methods: From January 2008 to December 2017,85 patients of esophageal carcinoma were respectively analyzed,which treated by definitive radiation therapy in The Fourth Hospital of Hebei Medical University.The data of re-radiotherapy treatment and peripheral blood cells index was compared and analyzed.Results: All patients were followed up to December 2017.The rate of follow-up was 93%.All the 85 patients received re-treatment for their local recurrence or lymphatic metastasis,the 1,2,3 years of overall survival rate were 31.4%、17.3%、12.6% respectively,and the median survival time was 5.6months.Among all these patients,including 53 cases received radiotherapy alone and 9 cases received chemo-radiotherapy,the 1,2,3 years overall survival rate were 36.2%、21.1%、14.5% respectively,and the median survival time was 5.8 months.Including 9 cases received chemotherapy alone,the1,2,3 years overall survival rate were 40%、13.3%、13.3% respectively,and the median survival time was 8.3 months.Including 8 cases received symptomatic and supportive treatment,the 1-year overall survival rate was 0%,and the median survival time was 4.0 months.Including 6 cases received radiotherapy unfinished,the 1-year overall survival rate was 0%,and the median survival time was 2.3 months.The univariate analysis showed that regimens of initial treatment,blood cells index before the secondary therapy,the interval period between initial treatment and recurrence,short-term effects and the dose ofre-irradiation were the important influencing factors for the survival time.The Cox multivariate analysis revealed that combined chemotherapy in initial treatment,the interval period between initial treatment and recurrence,the levels of ALB before the secondary therapy,pattern of re-treatment after local recurrence or lymphatic metastasis were independent prognostic influencing factors for influencing re-treatment.Conclusion:1.Re-irradiation plays an important role among the secondary treatment for patients of esophageal carcinoma with local regional Failure.Chemo-radiotherapy is recommended if patients could be tolerant and the prognosis is better.2.Combined chemo-radiotherapy in the initial treatment,the interval period between initial treatment and recurrence,the levels of ALB before the secondary therapy,patterns of re-treatment after local regional recurrence or lymphatic metastasis were independent prognostic influencing factors for re-treatment.Re-irradiation recommends prescription dose was 50~59.4Gy.3.Sufficient evaluating corporeity、nutrition、interval period between initial treatment and recurrence for patients of esophageal carcinoma with local regional failure after re-irradiation.