Preliminary analysis of recurrence-free survival after radical intensity-modulated radiotherapy combined with/without chemotherapy for upper cervical and thoracic esophageal cancer
10.3760/cma.j.cn113030-20210413-00158
- VernacularTitle:颈胸上段食管癌根治性调强放疗±化疗后无复发生存初步分析
- Author:
Wenbin SHEN
1
;
Hongmei GAO
;
Jinrui XU
;
Shuguang LI
;
Youmei LI
;
Shuchai ZHU
Author Information
1. 河北医科大学第四医院放疗科，石家庄 050011
- Keywords:
Esophageal neoplasm;
Cervical/upper thoracic esophageal cancer;
Recurrence-free survival;
Factor analysis
- From:
Chinese Journal of Radiation Oncology
2022;31(2):143-148
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the recurrence-free survival (RFS) and influencing factors of intensity-modulated radiotherapy±chemotherapy (IMRT±C) for the upper thoracic esophageal cancer.Methods:The medical records of 168 patients with cervical and upper thoracic esophageal cancer who met the inclusion criteria from January 2011 to December 2015 were retrospectively analyzed. The RFS was calculated by the Kaplan-Meier method. Multivariate prognostic analysis was performed by Cox models. The recurrence factors were identified by the Logistics model. Results:The 1-, 3-, and 5-year RFS rates were 67.8%, 38.0%, and 20.4%, respectively, and the median RFS was 21.9 months. The locoregional recurrence rate was 47.6%(80/168). The recurrence sites were local esophagus ( n=63), regional lymph nodes ( n=7), and local esophagus+ regional lymph node recurrence ( n=10). Multivariate analysis showed that hoarseness, cTstaging, combined with chemotherapy, 95%PTV 1 exposure dose and GTV average exposure dose were the influencing factors of RFS ( P=0.029, <0.001, 0.031, 0.038, 0.020). Logistics model showed that cTstaging, cNstaging, short-term efficacy, irradiationmethod, GTV maximum transverse diameter and PTV average exposure dose were the influencing factors of recurrence ( P=0.046, 0.022, 0.001, <0.001, 0.012, 0.001). Conclusions:Patients with cervical and upper thoracic esophageal cancer treated with radical IMRT combined with/without chemotherapy have a higher locoregional recurrence rate, and the recurrence rate is mainly the esophagus. The independent factors that affect RFS are different from the risk factors of recurrence.
