An analysis of the influencing factors for long-term survival in patients with esophageal carcinoma undergoing radical chemoradiotherapy

Abstract

Objective To analyze the efficacy of chemoradiotherapy in the treatment of esophageal carcinoma and its influencing factors, and to provide an optimal combination mode of chemoradiotherapy for treating esophageal carcinoma. Methods A retrospective analysis was performed on clinical data from 232 patients with esophageal carcinoma who were admitted to our hospital from January 2006 to December 2012 and received radical chemoradiotherapy. All patients received three-dimensional conformal radiotherapy or intensity-modulated radiotherapy as well as platinum-based chemotherapy. The overall survival (OS) and local control (LC) rates were calculated using the Kaplan-Meier method and analyzed using the Logrank test. Univariate and multivariate prognostic analyses were made by the log-rank test and the Cox proportional hazard model, respectively. Results In all patients, the 1-, 3-, and 5-year LC rates were 66.1%, 42.2%, and 38.5%, respectively; the median LC time was 24.4 months; the 1-, 3-, and 5-year OS rates were 73.3%, 37.2%, and 19.5%, respectively; the median OS time was 21 months. The univariate analysis revealed that T stage, N stage, clinical stage, irradiation range, and no less than 3 cycles of chemotherapy were influencing factors for OS (P=0.000, 0.000, 0.000, 0.030, 0.001) and LC (P=0.112, 0.031, 0.009, 0.074, 0.218). The multivariate analysis revealed that N stage, clinical stage, and no less than 3 cycles of chemotherapy were independent prognostic factors for OS (P=0.006, 0.000, 0.001). Conclusions The LC and long-term OS rates in patients with early-stage esophageal carcinoma can be substantially improved by radical chemoradiotherapy. The irradiation range and no less than 3 cycles of chemotherapy improve the long-term survival in patients. Key words: Esophageal neoplasms/three-dimensional radiotherapy; Esophageal neoplasms/chemotherapy; Prognosis