CLINICAL OUTCOME OF HIGH DOSE RADIOTHERAPY WITH OR WITHOUT CONCURRENT CHEMOTHERAPY IN ESOPHAGEAL CANCER (EC): A STUDY FROM NORTH – EAST INDIA

Abstract

OBJECTIVE: The objective of this study is to evaluate the clinical outcomes of high dose radiotherapy 63 Gray (Gy) with or without concurrent chemotherapy in Esophageal Cancer (EC) patients of North-East, India.
 MATERIAL AND METHODS: All reported EC patients belonging to different states of North-East and treated with radical intent with high dose radiotherapy with or without concurrent chemotherapy during the period 2017-2018 (2 years) at State Cancer Institute (SCI),Gauhati Medical College (GMC), Assam, India were included in the study. This study was retrospective in nature and two years retrospective data were analyzed for clinical outcome. Statistical analysis of data was done using Statistical Packages for Social Sciences (SPSS) and Disease Free Survival (DFS) was calculated using Kaplan-Meier method.
 RESULTS: Total 105 patients were treated during the period. All patients received a total dose of 63 Gy radiation. Out of 105 patients, 76 patients (72.4%) received concurrent chemotherapy and 29 patients (27.6%) not received chemotherapy only due to co-morbidities. Here, at first follow up, 89 (84.8%) patients showed complete response, 10 (9.5%) showed partial response and 6 (5.7%) showed progressive disease. Treatment related toxicities were assessed. None of the patient developed > Grade 2 toxicity.
 Further, Median Disease Free Survival (DFS) was 13 months with estimated mean was 16.98 months. Also, Standard Error (SE) =1.683, Confidence Interval (CI) =13.682-20.279.
 CONCLUSION: The high dose radiation (63 Gy) with concurrent chemotherapy as weekly regimen of Cisplatin or Paclitaxel plus Carboplatin is an effective definitive treatment of Stage I – IVA EC with acceptable toxicity. Median DFS is minimal in EC irrespective of the treatment. The rate of survival is decreasing rapidly before the median DFS and the rate of survival is constant after the Median DFS.