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＜journal article＞
Radical Radiotherapy for Hemodialysis Patients with Esophageal Cancer
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| Abstract | The aim of this study was to assess outcomes of radical radiotherapy for eight hemodialysis patients with esophageal cancer. A total of eight hemodialysis patients with esophageal cancer were treated ...by radical radiotherapy at Kyushu University Hospital in January 2008-June 2016. Their clinical stages were IA-IV. Radiation doses ranged from 60 to 70 Gy (median 65.4 Gy). Docetaxel was administered weekly to three patients. The initial response was graded according to the Response Evaluation Criteria in Solid Tumors (RECIST) ver. 1.1 and acute adverse events were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) ver. 4.0. The complete response (CR)rate was 50% (n=4). The T-stage of all four CR patients was T1b. The 1-year cumulative survival rate was 35%. Esophagitis (≧grade 3) was observed in four patients. Gastrointestinal bleeding occurred in two patients ; life-saving efforts were not successful. Dialysis patients with T1b esophageal cancer could achieve good initial treatment response by radical radiotherapy. However, their risk of severe mucosal disorders might be higher than that of non-dialysis patients. Chemotherapy in particular might make adverse events more severe. 目的：透析中の食道癌患者8 名に対する根治的放射線治療の成績について後方視的に検討する． 対象，方法：2008 年1 月から2016 年6 月に九州大学病院にて根治的放射線治療を受けた透析中の食道癌患者8 名を対象とした．臨床病期はIA 期からIV 期で，照射線量は60〜70 Gy（中央値65.4Gy）だった．3 名の患者に化学療法として，weekly docetaxel を投与した．初期治療効果はthe Response Evaluation Criteria in Solid Tumors (RECIST) ver. 1.1, 急性期有害事象はthe Common Terminology Criteria for Adverse Events (CTCAE) ver. 4.0 に基づいて評価した． 結果：完全奏効率は50％（n=4）で，いずれもTステージがT1b の症例だった．1年累積生存率は35％だった．Grade 3 以上の重篤な食道炎を4例で認めた．2 例で致死的な消化管出血を認めた． 結語：透析患者において，T1b の食道癌に対する根治的放射線治療は良好な初期治療効果を示した．一方で，重篤な粘膜炎のリスクが非透析患者に比べて高い可能性が示唆された．特に化学療法を併用する際には注意が必要である．show more |
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| Created Date | 2019.05.21 |
| Modified Date | 2023.11.17 |