Analysis of the failure patterns for esophageal cancer patients after radiotherapy with complete remission

Abstract

Objective To investigate the failure patterns for esophageal squamous cell carcinoma (ESCC) after radiotherapy and the influencing factors of recent efficacy.Methods 260 ESCC patients underwent radical radiotherapy and follow-up of 34.1 (6.2-105.2) months.The efficacy was observed to find locoregional recurrence and distant metastasis.Results Out of the 260 patients,91 achieved complete remission (CR) (35.0％),158 (60.8％) achieved partial remission (PR),and 11 (4.2％) achieved no remission (NR).Univariate analysis showed that gender (x2 =7.647,P ＜ 0.05),T stage (x2 =33.548,P ＜0.05),N stage(x2 =13.365,P ＜ 0.05),TNM stage(x2 =27.792,P ＜ 0.05),length oftumor(x2 =20.851,P ＜0.05),and gross tumor volume (GTV) (x2 =41.772,P ＜0.05)were the influencing factors for the recent efficacy.Locoregional recurrence was recognized in 75 patients,66 patients showed distant metastasis alone,and locoregional recurrence accompanied with distant metastasis was observed in 16 patients.The overall survival rate of the recurrence/metastasis patients was significantly lower than that of the patients without metastasis/recurrence (x2 =23.330,29.35,P ＜ 0.05).The recurrence/metastasis rate of the CR patients was significantly lower than that of the PR and NR patients respectively(x2 =11.248,20.301,P ＜ 0.05).The overall survival rate,local control rate,distant metastasis free survival rate,and disease-free survival rate of the CR patients were all significantly higher than those of the PR and NR patients respectively (x2 =83.080,41.340,72.640,40.010,P ＜ 0.05).Multivariate analysis showed that clinical T stage,clinical N stage,and recent curative effect were the independent influencing factors for the EC patients(HR =1.197,2.309,2.149,P ＜ 0.05).Conclusions Recent efficacy is the major influencing factor of the prognosis of ESCC,affecting the long-term survival of the patients after treatment,and closely related to the recurrence/metastasis as well.The prognosis of the CR patients is significantly better than that of both PR and NR patients. Key words: Esophageal squamous cell carcinoma; Three-dimensional conformal radiotherapy; Complete remission; Failure pattern