Concurrent chemoradiotherapy for 90 patients in different parts of esophageal carcinoma

Abstract

Objective To explore the effectiveness and esophageal strictures of concurrent chemoradiotherapy in patients with cervical and upper-thoracic esophageal cancer (EC) and middle-thoracic and lower-thoracic EC. Methods Between January 2011 and December 2014, ninety patients with different parts of EC were treated with radiotherapy combined with concurrent chemotherapy in People′s Hospital of Subei. The median irradiation dose was 60 Gy. The chemotherapy regimens consisted of Paclitaxel and Nedaplatin. Of all the patients, 48 patients had cervical and upper-thoracic EC, 42 patients had middle-thoracic and lower-thoracic EC. The response rates, the local control rates, the survival rates and esophageal strictures were eva-luated between two groups. Results The follow-up rate was 100%. The response rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 81.2% and 73.8% (χ2=0.717, P=0.397), respectively. The 1-year local control rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 90.3% and 71.8% (χ2=5.865, P=0.015), respectively. The 1-year survival rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 87.5% and 69.0% (χ2=4.580, P=0.032), respectively. The moderate-to-severe esophageal strictures rates of the patients with cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC were 55.6% and 29.4% (χ2=5.360, P=0.021), respectively. There were no significant differences in short-term effects between the cervical and upper-thoracic EC and middle-thoracic and lower-thoracic EC. The patients with cervical and upper-thoracic EC showed significantly higher 1-year local control rates, 1-year survi-val rates and esophageal strictures rates than those with middle-thoracic and lower-thoracic EC. Conclusion The effectiveness of concurrent chemoradiotherapy is better in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC, but the esophageal stenosis is more severe in the patients with cervical and upper-thoracic EC than in those with middle-thoracic and lower-thoracic EC. Key words: Esophageal neoplasms; Prognosis; Radiotherapy; Drug therapy