A retrospective study of californium-252 neutron brachytherapy combined with EBRT versus 3D-CRT in the treatment of esophageal squamous cell cancer.
BACKGROUND
We conducted a retrospective analysis on 884 patients who were diagnosed with esophageal squamous cell carcinoma (ESCC) and treated with either the neutron brachytherapy in combination with external beam radiotherapy (NBT + EBRT) or 3-dimensional conformal radiation therapy (3D-CRT) to determine the differences in efficacy and morbidity between the two treatment groups.


METHODS
The 884 ESCC patients treated with either NBT + EBRT or 3D-CRT between 2002 and 2012 were retrospectively reviewed and analyzed. Multivariable Cox regression was used to compare oncologic outcomes of the two groups of patients in the context of other clinically relevant variables. The acute and chronic toxicities associated with the two groups were compared using Fisher exact and log-rank tests, respectively.


RESULTS
Among the 884 patients, 545 received NBT + EBRT and 339 received 3D-CRT (i.e. EBRT-only). The age range is 39-95 years (median 66). The follow-up time range is 3-145 months (median 32). The analysis shows that the NBT + EBRT group has higher overall survival rate and local control rate than that of the 3D-CRT group. The acute toxicity effects were acceptable for both groups of patients with the NBT + EBRT group showing higher rates of leukopenia and thrombocytopenia and the 3D-CRT group showing higher rates on fistula and massive bleeding.


CONCLUSIONS
The patients treated with NBT + EBRT showed better oncologic outcomes than those treated with 3D-CRT. The toxicity effects were acceptable for both groups with the NBT + EBRT group showing higher rates on the acute effects and the 3D-CRT group showing higher rates on the late effects.
Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, Sichuan, 610041, P.R. China. littlecancer@163.com.
Qifeng
Q
Wang
Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, Sichuan, 610041, P.R. China. litaoxmf@126.com.
Tao
T
Li
Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, Sichuan, 610041, P.R. China. jinyiL126@163.com.
Jinyi
J
Lang
Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, Sichuan, 610041, P.R. China. jieW333@163.com.
Jie
J
Wang
Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, Sichuan, 610041, P.R. China. JianW@126.com.
Jian
J
Wang
Department of Radiation Oncology, Changzhi Cancer Hospital, Changzhi, Shanxi, 046000, P.R. China. lindenchangzhi@hotmail.com.
Huiming
H
Liu
Department of Radiation Oncology, Changzhi Cancer Hospital, Changzhi, Shanxi, 046000, P.R. China. jiaxitang@126.com.
Xitang
X
Jia
Department of Radiation Oncology, Changzhi Cancer Hospital, Changzhi, Shanxi, 046000, P.R. China. changzhiliubo@sina.com.
Bo
B
Liu
Medical Physics Program, School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332-0745, USA. chris.wang@nre.gatech.edu.
C-K Chris
CK
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D002142:Californium / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D004938:Esophageal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009502:Neutrons; D016016:Proportional Hazards Models; D011878:Radiotherapy / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies
D002142:Californium