Lymph Node Status after Neoadjuvant Chemoradiation Therapy for Esophageal Cancer according to Radiation Field Coverage

Q3 Medicine
Sang Yoon Kim, Samina Park, I. Park, Y. T. Kim, C. Kang
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引用次数: 2

Abstract

Background To explore the effect of radiation on metastatic lymph nodes (LNs) after neoadjuvant chemoradiation therapy (nCRT), we examined the metastatic features of LNs according to their inclusion in the radiation field. Methods The patient group included 88 men and 2 women, with a mean age of 61.1±8.1 years, who underwent esophagectomy and lymphadenectomy after nCRT. Dissected LNs were compared in terms of clinical suspicion of metastasis, nodal station, and inclusion in the radiation field. Results LN positivity did not differ between LNs that were inside (in-field [IF]) and outside (out-field [OF]) of the radiation field (IF: 40 of 465 [9%], OF: 40 of 420 [10%]; p=0.313). In clinical N+ nodal stations, IF stations had a lower incidence of metastasis than OF stations (IF/cN+: 16 of 142 [11%], OF/cN+: 9/30 [30%]; p=0.010). However, in clinical N- nodal stations, pathological positivity was not affected by whether the nodal stations were included in the radiation field (IF/cN-: 24 of 323 [7%], OF/cN-: 31 of 390 [8%]; p=0.447). Conclusion Radiation therapy for nCRT could downstage clinically suspected nodal metastasis. However, such therapy was ineffective when used to treat nodes that were not suspicious for metastasis. Because significant numbers of residual metastases were identified irrespective of coverage by the radiation field, lymphadenectomy should be performed to ensure complete removal of residual nodal metastases after nCRT.
食管癌症新辅助化疗放疗后淋巴结的放射野覆盖情况
背景为了探讨新辅助放化疗(nCRT)后放疗对转移性淋巴结(LNs)的影响,我们根据其在放疗场中的包含情况检查了LNs的转移特征。方法患者组包括88名男性和2名女性,平均年龄61.1±8.1岁,他们在nCRT后接受了食管切除术和淋巴结切除术。根据转移的临床怀疑、淋巴结位置和在辐射场中的包含性,对解剖的淋巴结进行比较。结果LN阳性率在辐射场内部(场内[IF])和外部(场外[OF])的LN之间没有差异(IF:465[9%],OF:420[10%];p=0.313),病理阳性率不受淋巴结是否包括在辐射场中的影响(IF/cN-:323例中的24例[7%],of/cN-:390例中的31例[8%];p=0.447)。然而,当用于治疗不可疑转移的淋巴结时,这种治疗是无效的。由于无论辐射场的覆盖范围如何,都发现了大量的残余转移灶,因此应进行淋巴结切除术,以确保nCRT后完全清除残余淋巴结转移灶。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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