Abstract:

Objective  To explore the correlation of tumor regression speed and prognosis,and evaluate the clinical value of barium swallow during radiotherapy for esophageal squamous cell carcinoma (ESCC). Methods  Clinical data from 81 patients with ESCC, treated with radiotherapy at the Cancer Center of Qilu Hospital of Shandong University were collected. Barium swallow was performed at every radiation dose of 10Gy until the radiation dose reached 70Gy. The X-ray appearance was classified according to the Zhengzhou Meeting criteria(1982). The patients were divided into 3 groups according to their tumor regression speed: group A had rapid regression, with the X-ray appearance classified as grade I orⅡat 40Gy; group B had slow regression, with the X-ray appearance classified as grade Ⅲ or Ⅳ at 40Gy, but as grade I orⅡat the end of radiation; group C had obvious residual tumors,with the X-ray appearance kept being classified as grade Ⅲ or IV at the end of radiation. Results  Complete response (CR) rates were 100.0％ in group A, 62.9％ in group B,and 26.7％ in group C (P<0.05);　the three-year survival rates were 45.8％, 22.2％, and 16.7％; the three-year survival rates of CR patients were 45.8％,35.3％ and 37.5％ (P>0.05). Conclusions  Short-term response is closely related to tumor regression speed, which is an important prognostic factor of ESCC.Tumor regression speed and esophageal barium swallow X-ray classification when the tumor dose reaches 40Gy can provide important information for subsequent treatment strategy.

Key words: Esophageal neoplasms; Radiotherapy; Tumor regression speed; Prognosis