Objective@#To evaluate the tolerability and short-term
efficacy of chemo-
radiotherapy in 125
patients with stage ⅡB-ⅣA esophageal
carcinoma after radical resection.@*
Methods@#We retrospectively evaluated the rate of completion,
toxicity and
survival of
patients undergoing adjuvant concurrent chemo-
radiotherapy after radical resection of esophageal
carcinoma from January 2004 to December 2014 in our institution. The
survival rate was determined by the Kaplan-Meier
method and analyzed using the log-rank test. Multivariate prognostic
analysis was performed using the Cox
proportional hazard model.@*Results@#122
patients received more than 50 Gy
dose (97.6%). A total of 52
patients received more than 5 weeks chemo-
radiotherapy (41.6%), while 73
patients underwent only 1-4 weeks (58.4%). The median following up was 48.4 months. 8
patients lost follow up (6.4%). The 1-year and 3-year overall
survival rate were 91.6% and 57.0%, respectively, with a median
survival time of 64.4 months. The 1-year and 3-year
disease free survival rate were 73.2% and 54.3%, respectively, with a median
disease free survival time of 59.1 months. The most common acute
complications associated with chemo-
radiotherapy were myelosuppression,
radiation esophagitis and
radiation dermatitis, the majority of which were Grade 1-2. Of the 125
patients, there were 59 cases of
recurrence, including 23 cases with local regional
recurrence, 26 cases with hematogenous
metastasis, and 8 cases with mixed
recurrence. Univariate
analysis showed that the numbers of concurrent
chemotherapy was associated with the overall
survival (P=0.006). But receiving more than 5 weeks was not the
prognostic factor compared to 1 to 4 weeks
chemotherapy (P=0.231).
Multivariate analysis showed that only the numbers of concurrent
chemotherapy was an independent
prognostic factor (P=0.010).@*Conclusions@#Postoperative
radiotherapy concurrent with weekly
chemotherapy could improve the overall
survival and decrease the
recurrence for stage ⅡB-ⅣA esophageal
carcinoma after radical resection. However, the completion rate of
chemotherapy was low, so it was necessary to explore reasonable regimens to improve the completion rate and carry out prospective
randomized controlled trial.