Analysis of outcomes and prognostic factors in 307 stages Ⅱ-Ⅲ esophageal cancer patients treated with concurrent chemoradiotherapy / 中华放射肿瘤学杂志

ABSTRACT

Objective To summarize the outcomes and prognostic factors in esophageal cancer (EC) patients.Methods A total of 307 EC patients of stages Ⅱ-Ⅲ were treated with concurrent chemoradiotherapy in our hospital from September 2006 to July 2014.There were 73 patients with stage Ⅱ and 234 with stage Ⅲ.The radiotherapy dose was 50-70 Gy (median 60 Gy).Concurrent chemoradiotherapy were used with fluorouracil plus platinum (PF,166),paclitaxel plus platinum (TP,82) or platinum only (P,59).The Kaplan-Meier method was used to calculate overall survival (OS) and progression-free survival (PFS) rates,the log-rank test was used for survival difference analysis and univariate prognostic analysis.The Cox regression model was used for multivariate prognostic analysis.Results The 1-,3-5-year OS and PFS rates were85.6％,53.8％,36.9％ and 74.6％,43.7％,33.1％,respectively.The median OS and PFS were 41.6 months and 29.8 months.The univariate analysis indicated that T stage,N stage,clinical stage,lesion location,lesion length and chemotherapy regimen were prognostic factors for OS and PFS (P=0.007 and 0.013,0.000 and 0.000,0.000 and 0.000,0.002 and 0.000,0.141 and 0.005,0.018 and 0.165).Multivariate analysis showed that T stage,N stage,lesion location and chemotherapy regimen were prognostic factors for OS (P =0.024,0.000,0.007 and 0.028),lesion location,lesion length and N stage were prognostic factors for PFS (P=0.004,0.033 and 0.035).The median OS and PFS for EC patients treated by total dose 50-60 Gy,＞60-70 Gy were 47.4 months,37.8 months (P=0.469) and34.1 months,25.1 months (P=0.0.233),therewere no statistic difference.Conclusions The outcome of EC patients treated with concurrent chemoratherapy could obtain a long-term survival,combination chemotherapy is superior to single drug,there are no statistical difference between high-dose and low-dose,and the acute toxic effects can be tolerated.