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
Lu Na, Wang Xin, Li Chen, Wang Lan, Chen Junqiang, Zhang Wencheng, Wang Xiaomin, Ge Xiaolin, Shen Wenbin, Hu Miaomiao, Yuan Qianqian, Xu Yonggang, Hao Chongli, Zhou Zhiguo, Qie Shuai, Xiao Zefen, Zhu Shuchai, Han Chun, Qiao Xueying, Pang Qingsong, Wang Ping, Zhao Yidian, Sun Xinchen, Zhang Kaixian, Li Ling, Li Gaofeng, Liu Miaoling, Wang Yadi
Abstract
ObjectiveTo evaluate the prognostic factors of T1-2N0M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy.
MethodsThe 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.
ResultsThe 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.
ConclusionsDefinitive radiotherapy is a promising therapeutic method in patients with T1-2N0M0 ESCC. Patients′ age, tumor diameter and tumor volume may impact patients′ prognosis.
Key words:
Esophageal neoplasms; Radiotherapy; Three-dimensional conformal radiotherapy; Intensity-modulated radiotherapy; Prognosis
Contributor Information
Lu Na
Department of Radiation Oncology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
Wang Xin
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
Li Chen
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
Wang Lan
Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Chen Junqiang
Department of Radiation Oncology, Fujian Cancer Hospital/Fujian Medical University Cancer Hospital, Fuzhou 350014, China
Zhang Wencheng
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
Wang Xiaomin
Department 4th of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
Ge Xiaolin
Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Shen Wenbin
Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Hu Miaomiao
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277599, China
Yuan Qianqian
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277599, China
Xu Yonggang
Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Hao Chongli
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277599, China
Zhou Zhiguo
Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Qie Shuai
Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
Xiao Zefen
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
Zhu Shuchai
Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Han Chun
Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Qiao Xueying
Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
Pang Qingsong
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
Wang Ping
Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Cancer, Tianjin 300060, China
Zhao Yidian
Department 4th of Radiation Oncology, Anyang Cancer Hospital, Anyang 455000, China
Sun Xinchen
Department of Radiation Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
Zhang Kaixian
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277599, China
Li Ling
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277599, China
Li Gaofeng
Department of Radiation Oncology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Liu Miaoling
Department of Radiation Oncology, Affiliated Hospital of Hebei University, Baoding 071000, China
Wang Yadi
Department of Radiation Oncology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
