Analysis of outcomes and prognostic factors in 307 stages II-III esophageal cancer patients treated with concurrent chemoradiotherapy

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) and 34.1 months, 25.1 months (P=0.0.233), there were 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. Key words: Esophageal neoplasms/radiotherapy; Esophageal neoplasms/chemotherapy; Prognosis