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Objective@#To investigate the clinical significance of radiotherapy for stage Ⅳ esophageal cancer.@*Methods@#Clinical data of 133 stage Ⅳ esophageal cancer patients admitted to our hospital from 2012 to 2018 were retrospectively analyzed. All patients were assigned into the radiochemotherapy (n=89) and chemotherapy groups (n=44). The survival analysis was performed by Kaplan-Meier method. The multivariate prognostic analysis was conducted by Cox’s regression model.@*Results@#The 1-, 2-and 3-year overall survival rates of the entire cohort were 53.5%, 20.4% and13.6% respectively. Cox’s regression analysis showed that gender, ECOG score, number of distant metastases, and whether the primary lesions received radiotherapy were the independent prognostic factors (all P<0.05). The 1-, 2-and 3-year survival rates in the radiochemotherapy group were 61%, 29% and19%, and 40%, 4%, 0% in the chemotherapy group, respectively. In the radiochemotherapy group, the progression-free survival (PFS) and local progression-free survival (LPFS) were 8 months and 12.6 months, significantly longer compared with 4.7 months and 5.3 months in the chemotherapy group (both P<0.05). The OS of patients receiving dose> 50Gy and ≤50Gy was 14.3 months and 8.2 months (P<0.05), 8.6 months and 2.8 months for the PFS (P<0.05), and 15.2 months and 4.7 months for the LRFS (P<0.05), respectively. The number of distant metastases and the clinical efficacy for primary lesions were the independent prognostic factors in the radiochemotherapy group (both P<0.05).@*Conclusion@#Radiotherapy can improve the clinical prognosis of patients with stage Ⅳ esophageal cancer.
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Objective To investigate the clinical significance of radiotherapy for stage Ⅳ esophageal cancer.Methods Clinical data of 133 stage Ⅳ esophageal cancer patients admitted to our hospital from 2012 to 2018 were retrospectively analyzed.All patients were assigned into the radiochemotherapy (n=89)and chemotherapy groups (n=44).The survival analysis was performed by Kaplan-Meier method.The multivariate prognostic analysis was conducted by Cox's regression model.Results The 1-,2-and 3-year overall survival rates of the entire cohort were 53.5％,20.4％ and13.6％ respectively.Cox's regression analysis showed that gender,ECOG score,number of distant metastases,and whether the primary lesions received radiotherapy were the independent prognostic factors (all P＜0.05).The 1-,2-and 3-year survival rates in the radiochemotherapy group were 61％,29％ and19％,and 40％,4％,0％ in the chemotherapy group,respectively.In the radiochemotherapy group,the progression-free survival (PFS) and local progression-free survival (LPFS) were 8 months and 12.6 months,significantly longer compared with 4.7 months and 5.3 months in the chemotherapy group (both P＜0.05).The OS of patients receiving dose＞50Gy and ≤50Gy was 14.3 months and 8.2 months (P＜0.05),8.6 months and 2.8 months for the PFS (P＜0.05),and 15.2 months and 4.7 months for the LRFS (P＜0.05),respectively.The number of distant metastases and the clinical efficacy for primary lesions were the independent prognostic factors in the radiochemotherapy group (both P＜0.05).Conclusion Radiotherapy can improve the clinical prognosis of patients with stage Ⅳ esophageal cancer.
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In China, radical esophagectomy remains the main strategy for resectable esophageal cancer. However, the high locoregional recurrence rate and hematogenous metastasis rate are the main causes of surgical failure. Therefore, whether postoperative adjuvant therapy can become one of the important means for esophageal cancer remains controversial. In this article, the research progress on the postoperative recurrent pattern and adjuvant therapy for esophageal carcinoma was reviewed to provide references for clinicians.
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Objective To evaluate the survival and prognostic factors of esophageal cancer treated with definitive ( chemo ) radiotherapy by applying novel radiation techniques including three-dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT). Methods Clinical data of 2762 patients with non-operated esophageal squamous cell carcinoma who underwent definitive ( chemo ) radiotherapy from 2002 to 2016 in 10 hospitals were retrospectively analyzed.The prognostic factors were also identified and analyzed. Results The median follow-up time was 60. 8 months. The 1-, 2-, 3-and 5-year overall survival (OS) of all patients was 71. 4％,48. 9％,39. 3％,and 30. 9％,respectively.The 1-,2-,3-and 5-year progression-free survival (PFS) was 59.5％,41.5％,35.2％,and 30％,respectively.The median survival was 23 months.The median time to progression was 17. 2 months.Multivariate analysis demonstrated that age, primary tumor location, clinical stage, tumor target volume, EQD2 and treatment mode were the independent prognostic factors for OS.Primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS. Conclusions In this first large-scale multi-center retrospective analysis of definitive ( chemo) radiotherapy for esophageal squamous cell carcinoma in China, the 5-year OS of patients with esophageal squamous cell carcinoma is significantly improved by 3DCRT, IMRT combined with chemotherapy drugs. However, the findings remain to be validated by prospective clinical trials with high-level medical evidence.
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Along with the intensification of the aging trend,the proportion of elderly patients suffering from esophageal cancer has been ever increased.Radiotherapy plays a pivotal role in the treatment of esophageal cancer in the elderly patients considering their relatively poor tolerance of surgery and high risk of postoperative complications.In this review,the development in the comprehensive treatment of esophageal cancer in the elderly was summarized.