Outcomes and prognostic factors for patients with cervical esophageal cancer undergoing definitive radiotherapy or chemoradiotherapy

  • Xin-xin Du Department of Radiotherapy, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot; Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China; Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Genecology, University of Cologne, Cologne, Germany
  • Rong Yu Department of Radiotherapy, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
  • Zhen-fei Wang Department of Radiotherapy, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University; Tumor Molecular Diagnostic Laboratory, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
  • De-cheng Du Department of Radiotherapy, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
  • Qiao-yun Liu Department of Radiotherapy, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
  • Run-mei Wang Department of Radiotherapy, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
  • Shi-rong Kang Department of Thoracic Surgery, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
  • Hao Yang Department of Radiotherapy, Inner Mongolia Cancer Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
Keywords: Cervical esophageal carcinoma, radiotherapy, chemoradiotherapy, prognosis, disease management, survival, 3DCRT, IMRT, concurrent chemoradiotherapy

Abstract

Cervical esophageal cancer (CEC) is uncommon, accounting for less than 5% of all esophageal cancers. The management of CEC is controversial. This study investigated treatment outcomes and prognostic factors of survival in CEC patients undergoing definitive radiotherapy or concurrent chemoradiotherapy (CCRT). Ninety-one CEC patients were treated by intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3DCRT) between July 2007 and September 2017. The mean prescription dose was 64 Gy (range 54-70 Gy) delivered as 1.8-2.2 Gy per fraction per day, 5 days a week. Out of 91 patients, 34 received concurrent cisplatin-based chemotherapy (CT) including 18 patients who also received neoadjuvant CT. Overall survival (OS), locoregional failure-free survival (LRFFS), and progression-free survival (PFS) were estimated by the Kaplan–Meier method. Prognostic factors of survival were determined in univariate (log-rank test) and multivariate (Cox proportional hazard model) analysis. Treatment-related toxicity was also assessed. Median follow-up time for all patients was 19 months. Two-year OS, LRFFS and PFS of all patients were 58.2%, 52.5% and 48.1%, respectively. Clinical stage was an independent prognostic factor for OS (HR = 2.35, 95% CI: 1.03-5.37, p = 0.042), LRFFS (HR = 3.84, 95% CI: 1.38-10.69, p = 0.011), and PFS (HR = 2.68, 95% CI: 1.11-6.45, p = 0.028). Hoarseness was an independent prognostic factor for OS (HR = 2.10, 95% CI: 1.05-4.19, p = 0.036). CCRT was independently associated with better LRFFS (HR = 0.33, 95% CI: 0.14-0.79, p = 0.012). 3DCRT and IMRT with concurrent CT is well-tolerated and may improve local tumor control in CEC patients. Advanced clinical stage and hoarseness are adverse prognostic factors for OS, LRFFS, and PFS in CEC.

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Outcomes and prognostic factors for patients with cervical esophageal cancer undergoing definitive radiotherapy or chemoradiotherapy
Published
2019-05-20
How to Cite
1.
Du X- xin, Yu R, Wang Z- fei, Du D- cheng, Liu Q- yun, Wang R- mei, Kang S- rong, Yang H. Outcomes and prognostic factors for patients with cervical esophageal cancer undergoing definitive radiotherapy or chemoradiotherapy. Bosn J of Basic Med Sci [Internet]. 2019May20 [cited 2019Aug.21];19(2):186-94. Available from: http://www.bjbms.org/ojs/index.php/bjbms/article/view/3873
Section
Translational and Clinical Research