Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8759609 | The Kaohsiung Journal of Medical Sciences | 2018 | 9 Pages |
Abstract
We investigated which prognostic factor could improve survival for esophageal cancer patients who received definite concurrent chemoradiation (CCRT). Eighty patients with age â¥18, Karnofsky Performance Scale (KPS) â¥Â 60, and clinical stage T1-4N0-3M0 esophageal squamous cell carcinoma were enrolled from July 2004 to December 2015. They underwent definite intensity-modulated radiotherapy (IMRT) with or without simultaneous integrated boost to the primary tumor, and reception of concurrent chemotherapy â¥Â 1 cycle. The primary endpoints were overall survival (OS), locoregional progression-free survival (LRPFS) and distant metastasis-free survival (DMFS). The median follow-up duration for alive patients was 21.5 months. The rates of 2-, 3- and 5-year OS/LRPFS/DMFS were 23.8%/53.5%/49.3%, 19.1%/44.6%/49.3%, and 13.0%/44.6%/43.9%, respectively. Only the non-clinical complete response (non-cCR) after CCRT was an independent poor prognostic factor in OS (HR 3.101, 95% CI 1.535-6.265, p = 0.0016). Radiation dose >50.4 Gy and chemotherapy â¥4 cycles significantly predicted better LRPFS (p = 0.0361 and 0.0163, respectively). Poorly differentiated tumor and stage III disease have poor DMFS (p = 0.0336 and 0.0411, respectively), and chemotherapy â¥Â 4 cycles was a better predictor (p = 0.0004). In subgroup analysis, patients who received radiation dose â¤50.4 Gy with concurrent chemotherapy â¥4 cycles had the best survival outcome with 1-, 2-, 3- and 5-year survival rates of 73.7%, 39.4%, 31.5% and 17.5%, respectively. In conclusion, definite radiotherapy with concurrent chemotherapy â¥4 cycles improved the survival for patients with inoperable or locally-advanced esophageal squamous cell carcinoma.
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Authors
He-Yuan Hsieh, Chung-Ping Hsu, Hui-Ling Yeh, Cheng-Yen Chuang, Jai-Fu Lin, Chen-Fa Chang,