Analysis of the prognostic factors in esophageal carcinoma patients undergone concurrent chemoradiotherapy

Abstract

Objective To investigate the prognostic factors regarding overall survival in locally advanced stage of esophageal squamous cell carcinoma (ESCC) patients after receiving concurrent chemoradiotherapy (CRT).Methods Each of 80 patients with locally advanced ESCC was treated by doxtel 135-175 mg/m2 d1 and cisplatin 40 mg/m2 d2,3 combined with radiotherapy 60 Gy.ECOG (0-1),tumor locations,tumor sizes,TNM classifications as well as the levels of CA199,SCC-Ag were detected before concurrent treatments and 4 weeks after treatment.The relationship wasanalyzed between the prognosis of disease and CA199,SCC-Ag levels.Each index was studied by Cox statistical regression analysis and P value was determined.Results All patients had completed 4 cycles' treatments successfully.The major adverse effects included neutrophilic granuloaytopenia,calvities,nausea,emesis and diarrhea.The severe effect was Ⅲ degree neutrophilic granuloaytopenia for 2 cases (2.5 ％),all the side-affect had recovered after symptomatic treatments.The median survival time were 50 months and 72.5 months in the patients who were greater than 60 year-old and less than or equal to 60 year-old,respectively (P =0.004).Regarding to 5-year overall survival,the figures were 73.3 ％,69.4 ％,41.7 ％ and 0 in the patients with cT1-2N1M0,cT3N1M0,cT4NoM0 and cT4N1M0 classification,respectively (P =0.024),they were 42.9 ％,70.0 ％,and 60.9 ％ in the patients with upper thoracic esophagus,middle thoracic esophagus,and lower thoracic esophagus,respectively (P =0.971),they were 100 ％ in the patients with ECOG 0 and 54.1％ in the patients with ECOG 1 (P =0.044),they were 86.7 ％ in the patients with CA199≤37 kU/L,and 52.0 ％ in the patients with CA199 more than 37 kU/L (P =0.008),they were 95.5 ％ in the patients with SCC-Ag≤ 1.9 μg/L,and 53.4 ％ with ＞1.9 μg/L (P =0.012).Conclusion For ESCC patients treated with CRT,the age,TNM stage,ECOG,CA199 and SCC-Ag levels are independent forecasting factors regarding their overall survival. Key words: Esophageal neoplasms; Concurrent chemoradiotherapy; Prognosis; CA199; SCC-Ag