Analysis of prognostic factors of advanced esophageal carcinoma with concurrent radiotherapy and chemotherapy

Abstract

Objective To retrospectively analyze the prognostic factors of advanced esophageal carcinoma (EPC) with concurrent chemoradiotherapy. Methods A total of 200 advanced EPC patients between January 2008 and December 2011 were reviewed, and all of them received concurrent chemoradiotherapy, either IMRT or CRT. Among them, there were 92 and 108 patients in the IMRT and CRT group, respectively. The chemotherapy scheme was paclitaxel combined with different platinum drugs (cisplatin, nedaplatin, oxaliplatin or lobaplatin). The number of chemotherapy cycles was 2-4. Results Patients who received IMRT had a significant higher 3-year overall survival (OS) than that who received CRT (63.6 % vs 38.9 %, χ2=12.102, P=0.001). Three-year OS differed no significantly between different chemotherapy regimens. There were 44.6 % , 57.5 % , 52.5 % and 52.5 % for those who received cisplatin, nedaplatin, oxaliplatin and lobaplatin, respectively (χ2=2.756, P=0.431). Patients received different cycles of chemotherapy had comparable treatment outcome, and the overall survival were 44.1 %, 51.6 % and 57.4 % for those who underwent 2, 3 and 4 chemotherapy cycles at 3 years, without any statistical significance (χ2=2.497, P=0.287). Univariate analysis indicated that lesion length on X-ray, M stage, 6th edition UICC staging and radiotherapy methods were the potential predictive factors. Multivariate analysis shown that gender, lesion length on X-ray and radiotherapy methods were the significant prognostic factors. Conclusion The significant prognostic factors for advanced EPC with concurrent chemoradiotherapy are mainly lesion length on X-ray and radiotherapy methods. Key words: Esophageal neoplasms; Concurrent chemoradiotherapy; Radiotherapy; Drug therapy, combination; Prognostic factors