Results of the 1999 2001 Japanese Patterns of Care Study for Patients Receiving Definitive Radiation Therapy without Surgery for Esophageal Cancer

Abstract

The third Japanese Patterns of Care Study (JPCS) was conducted for esophageal cancer patients receiving radiotherapy (RT). The aim of this study is to analyse the data of the non-surgery group. Of the 621 patients receiving RT from 1999 to 2001, 385 non-surgical patients were analysed. Median age was 71 years and 85% were male. Karnofsky performance status (KPS) was > or =80 in 71% and better in T1 cases than in T2-4 cases. Ninety-nine per cent had squamous cell carcinoma and 56% had the main lesion in the middle thoracic esophagus. Twenty-one per cent had T1 disease, 12% T2, 38% T3 and 29% T4. Endoscopic ultrasound was used in 29% and mainly in T1 cases. Endoscopic mucosal resection was performed in 40% of mucosal cancer. Utilization of chemotherapy had remarkably increased compared with the 1995-1997 JPCS (61% versus 35%), however was significantly less in T1 cases than in T2-4 cases. The most frequently used agents for concurrent use were 5-fluorouracil and cisplatin. The median total dose of external beam RT (ERT) was 60 Gy and did not differ between T1 and T2-4 cases and also in comparison with the 1995-1997 JPCS. Brachytherapy was used in 10% and mainly in T1 cases. Utilization of chemotherapy had remarkably increased. However the common treatment for T1 cases was RT alone. The standard dose of ERT was 60 Gy in spite of the increase in chemotherapy administration. Moreover, this survey showed significant differences in many parameters of treatment process between T1 and T2-4 cases.