RESUMEN
BACKGROUND AND OBJECTIVE: Intensity-modulated radiotherapy (IMRT) for esophageal carcinoma has seldom been reported; its clinical efficacy and toxicity are still uncertain. This study was to evaluate the short-term efficacy of IMRT on esophageal carcinoma, and to observe adverse events. METHODS: From June 2006 to March 2008, 37 patients with cervical and thoracic esophageal carcinoma were treated with IMRT. The treatment response, local control and survival were evaluated and the adverse events were observed. RESULTS: The minimal prescription dose of 100% of gross tumor volume (GTV D100) 95% of clinical target volume (CTV D95), and 95% of planning target volume (PTV D95) were (6 456+/-172)cGy, (6 293+/-145)cGy, and (5 988+/-53)cGy, respectively. The volumes of lung receiving irradiation of >or= 5 Gy, >or=10 Gy, >or=20 Gy and >or=30 Gy were (59.6+/-12.8)%, (39.5+/-8.7)%, (22.0+/-5.4)%, and (12.0+/-4.3)%, respectively. The mean lung dose (MLD) was (1 178+/-248)cGy. The overall response rate was 97.3% (36/37). The patients were followed-up for 8-29 months (median,13 months). The occurrence rates of grades 3-4 acute and late esophagitis, grades 2-4 acute and late pneumonitis were 16.2% and 7.2%, 10.8% and 8.1%. The 1-and 2-year local control rates were 72.9% and 72.9%. The 1-and 2-year overall survival rates were 80.9% and 67.4%. The 1-and 2-year disease-free survival rates were 73.5% and 51.4%. Local recurrence (69.2%) was the main reason of treatment failure. CONCLUSION: IMRT is an effective treatment for esophageal carcinoma with low occurrence of acute and late radiation-related pneumonitis, but local failure is still a main problem for treatment of patients with esophageal carcinoma.
Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Neoplasias Esofágicas/radioterapia , Radioterapia de Intensidad Modulada/métodos , Adulto , Anciano , Supervivencia sin Enfermedad , Esofagitis/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Órganos en Riesgo , Neumonía/etiología , Dosificación Radioterapéutica , Planificación de la Radioterapia Asistida por Computador , Radioterapia de Intensidad Modulada/efectos adversos , Inducción de Remisión , Tasa de SupervivenciaRESUMEN
BACKGROUND & OBJECTIVE: CD117 is highly expressed in acute non-lymphoblastic leukemia (ANLL), and may be used as an immunologic marker of myeloid leukemia. However CD117 is also expressed in some acute lymphoblastic leukemia (ALL) cases. CD34 is highly expressed in both ALL and ANLL. This study was to explore the clinical significance of the co-expression of CD117/CD34 in adult patients with acute leukemia. METHODS: Flow cytometry (FCM) was used to detect the positive rate and expression level of CD117 in bone marrow mononuclear cells (BMMNCs) of 92 patients with ALL and 81 patients with ANLL. The difference between the rates of CD117 expression and CD117/CD34 co-expression in ALL patients and the difference of CD117/CD34 co-expression between ALL and ANLL patients were compared. Twenty healthy individuals were set as controls. RESULTS: The positive rate of CD117 was significantly lower in ALL than in ANLL (15.2% vs. 71.6%, P<0.001). The co-expression rate of CD117/CD34 was significantly lower in ALL than in ANLL (5.4% vs. 55.5%, P<0.001). The positive rate of CD117 was significantly higher than co-expression rate of CD117/CD34 in ALL (15.2% vs. 5.4%, P=0.029). CONCLUSIONS: CD117 may be used as an immunologic marker for acute myeloid leukemia. The co-expression rate of CD117/CD34 is lower than that of CD117 alone in ALL, and therefore, this may be used in the exclusive diagnosis of ALL.