Chemoradiotherapy of esophageal carcinoma
Clinical efficacy and failure pattern in patients with cervical esophageal cancer treated with definitive chemoradiotherapy

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Abstract

Background

Data on cervical esophageal cancer (CEC) based on modern radiotherapy technique are rare. We aimed to analyze the clinical efficacy and failure pattern of patients with CEC who underwent definitive chemoradiotherapy.

Methods

Between February 2002 and October 2013, 102 patients with CEC treated with definitive chemoradiotherapy were retrospectively analyzed. All patients received concurrent platinum-based chemotherapy with conformal radiotherapy (50–70 Gy in 25–35 fractions, 5 fractions per week over 5–7 weeks). Overall survival (OS), progression-free survival (PFS) and loco-regional failure-free survival (LRFFS) were calculated.

Results

The 3-year OS, PFS and LRFFS rates for the entire sample were 39.3%, 33.6% and 35.3%, respectively. During follow-up, 32, 26, and 41 patients had developed local, regional, and distant failure, respectively. Sex and hoarseness were independent prognostic indicators for OS (P = 0.011, P < 0.001; respectively) and PFS (P = 0.008, P = 0.001; respectively). Hoarseness was the only independent prognostic factor for LRFFS (P = 0.002).

Conclusions

Distant metastasis was the most common failure pattern in CEC patients undergoing definitive chemoradiotherapy. Hoarseness was an independent prognostic factor for OS, PFS, and LRFFS.

Section snippets

Materials and methods

Between February 2002 and October 2013, we respectively reviewed 102 patients diagnosed with CEC and who received definitive chemoradiotherapy at the Sun Yat-sen University Cancer Center. The primary tumor center was between the cricopharyngeus muscle and the thoracic esophagus inlet [7]. All patients had pathologically proven squamous cell carcinoma with or without superior hypopharyngeal extension or inferior thoracic esophageal extension. Patients recruited to our study had no distant organ

Results

The patient characteristics are detailed in Table 1. According to the AJCC staging system (6th edition), 32 patients had stage II disease; 70 patients had stage III disease. Fifty-six patients were treated with 3DCRT; 46 received IMRT. The median radiation dose was 60 Gy (range, 50–70 Gy) and only 12 patients received a total dose of <60 Gy. A total of 86 patients received radiation doses of 60–66 Gy and 4 patients received >66 Gy (including three who received 70 Gy).

At a median follow-up interval of

Discussion

Due to relatively low morbidity, reports on the clinical efficacy and failure pattern of CEC treatment are limited. Previous studies on the efficacy of radiotherapy with or without chemotherapy for treating CEC reported 3-year survival rates of 22–37.9% following short-term observation [15], [16], [17], [18]. In this study, the 3-year OS, PFS and LRFFS rates were 39.3%, 33.6% and 35.3%, respectively. There were no stage IV patients in our study and all patients received conformal radiotherapy

Funding source

This work was supported by a grant from the Sci-Tech Project Foundation of Guangdong Province (Grant No. 2012B031800287).

Conflicts of interest

The authors have declared no conflicts of interest.

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  • Cited by (0)

    1

    Peng Zhang and Mian Xi contributed equally to this work.

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