Abstract:

Objective To compare the clinical efficacy, adverse reactions and prognosis of different radiotherapy schemes in the treatment of advanced esophageal squamous cell carcinoma.Methods The clinical data of 60 patients with stage ⅣB esophageal squamous cell carcinoma who received radiotherapy in Rugao People's Hospital of Jiangsu Province from January 2015 to January 2020 were retrospectively analyzed. According to the radiation doses, the patients were divided into standard dose group (total radiation dose <50.4 Gy) and high dose group (total radiation dose ≥50.4 Gy), with 30 patients in each group. The scores of dysphagia before and after treatment were analyzed by Wilcoxon signed-rank test. The radiotherapy effective rate, remission rate of dysphagia and incidence of adverse reactions were analyzed by χ ² test. Survival analysis was carried out by Kaplan-Meier and log-rank test was used to compare the prognosis of the two groups. Results There were no significant differences in dysphagia scores between standard dose group and high dose group before and after radiotherapy (Z=1.232, P=0.876; Z=1.506, P=0.278). The dysphagia symptoms were relieved after radiotherapy in all patients, and the dysphagia score was significantly higher than that before radiotherapy (Z=6.347, P<0.001). The radiotherapy effective rates in the standard dose group and high dose group were 76.7% (23/30) and 83.3% (25/30) respectively, with no statistically significant difference (χ²=0.417, P=0.519). The remission rates of dysphagia in the two groups were 80.0% (24/30) and 90.0% (27/30) respectively, with no statistically significant difference (χ ²=0.523, P=0.470). The incidences of adverse reactions in the two groups were 43.3% (13/30) and 83.3% (25/30) respectively, with a statistically significant difference (χ ²=10.335, P=0.001). The median overall survival in the standard dose group and high dose group were 11 months and 9 months respectively, with no statistically significant difference (χ ²=1.490, P=0.256). Conclusion There are no statistical differences in short-time efficacy, symptom remission and long-term prognosis between the standard dose group and the high dose group in patients with advanced esophageal squamous cell carcinoma. However, the incidence of adverse reactions in patients receiving standard dose radiotherapy is low, which is worthy of clinical application.

Key words: Esophageal neoplasms, Neoplasms,squamous cell, Neoplasm metastasis, Radiotherapy, Treatment outcome