Prognostic analysis of definitive radiotherapy for early esophageal carcinoma(T1-2N0M0): a multi-center retrospective study of Jing-Jin-ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group

Na LU; Xin Wang; Chen LI; Lan Wang; Junqiang Chen; Wencheng Zhang; Xiaomin Wang; Xiaolin GE; Wenbin Shen; Miaomiao HU; Qianqian Yuan; Yonggang XU; Chongli Hao; Zhiguo Zhou; Shuai Qie; Zefen Xiao; Shuchai Zhu; Chun Han; Xueying Qiao; Qingsong Pang; Ping Wang; Yidian Zhao; Xinchen Sun; Kaixian Zhang; Ling LI; Gaofeng LI; Miaoling Liu; Yadi Wang

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Prognostic analysis of definitive radiotherapy for early esophageal carcinoma(T1-2N0M0): a multi-center retrospective study of Jing-Jin-ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group

VernacularTitle: T1～2N0M0期食管癌根治性放疗的预后分析：泛京津冀食管肿瘤多中心协作组多中心回顾性研究(3JECROG R－01H)
Author: Na LU ¹ ; Xin WANG ² ; Chen LI ² ; Lan WANG ³ ; Junqiang CHEN ⁴ ; Wencheng ZHANG ⁵ ; Xiaomin WANG ⁶ ; Xiaolin GE ⁷ ; Wenbin SHEN ³ ; Miaomiao HU ⁸ ; Qianqian YUAN ⁸ ; Yonggang XU ⁹ ; Chongli HAO ⁸ ; Zhiguo ZHOU ³ ; Shuai QIE ¹⁰ ; Zefen XIAO ² ; Shuchai ZHU ³ ; Chun HAN ³ ; Xueying QIAO ³ ; Qingsong PANG ⁵ ; Ping WANG ⁵ ; Yidian ZHAO ⁶ ; Xinchen SUN ⁷ ; Kaixian ZHANG ⁸ ; Ling LI ⁸ ; Gaofeng LI ⁹ ; Miaoling LIU ¹⁰ ; Yadi WANG ¹
Author Information

1. Department of Radiation Oncology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
2. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
3. Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
4. Department of Radiation Oncology, Fujian Cancer Hospital/Fujian Medical University Cancer Hospital, Fuzhou 350014, China
5. Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
6. Department 4th of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
7. Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
8. Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277599, China
9. Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
10. Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
Publication Type:Clinical Trail
Keywords: Esophageal neoplasms; Radiotherapy; Three-dimensional conformal radiotherapy; Intensity-modulated radiotherapy; Prognosis
From: Chinese Journal of Oncology 2020;42(2):139-144
CountryChina
Language:Chinese
Abstract: Objective:To evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy.
Methods:The clinical data of 196 patients with T1-2N0M0 ESCC who were treated with definitive radiotherapy in 10 hospitals were retrospectively analyzed. All sites were members of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG). Radiochemotherapy were applied to 78 patients, while the other 118 patients received radiotherapy only. 96 patients were treated with three-dimensional conformal radiotherapy (3DCRT) and 100 treated with intensity-modulated radiotherapy (IMRT). The median dose of plan target volume(PTV) and gross target volume(GTV) were both 60 Gy. The median follow-up time was 59.2 months. Log rank test and Cox regression analysis were used for univariat and multivariate analysis, respectively.
Results:The percentage of normal lung receiving at least 20 Gy (V₂₀) was (18.65±7.20)%, with average dose of (10.81±42.05) Gy. The percentage of normal heart receiving at least 30 Gy (V₃₀) was (14.21±12.28)%. The maximum dose of exposure in spinal cord was (39.65±8.13) Gy. The incidence of radiation pneumonia and radiation esophagitis were 14.80%(29/196) and 65.82%(129/196), respectively. The adverse events were mostly grade 1-2, without grade 4 toxicity. Median overall survival (OS) and progression-free survival (PFS) were 70.1 months and 62.3 months, respectively. The 1-, 3- and 5-year OS rates of all patients were 75.1%、57.4% and 53.2%, respectively. The 1-, 3- and 5-year PFS rates were 75.1%、57.4% and 53.2%, respectively. Multivariate analysis demonstrated that patients′age (HR=1.023, P=0.038) and tumor diameter (HR=1.243, P=0.028)were the independent prognostic factors for OS, while tumor volume were the independent prognostic factor for PFS.
Conclusions:Definitive radiotherapy is a promising therapeutic method in patients with T1-2N0M0 ESCC. Patients′ age, tumor diameter and tumor volume may impact patients′ prognosis.