Preliminary analysis of recurrence-free survival after radical intensity-modulated radiotherapy combined with/without chemotherapy for upper cervical and thoracic esophageal cancer
Shen Wenbin1, Gao Hongmei2, Xu Jinrui1, Li Shuguang1, Li Youmei1, Zhu Shuchai1
1Department of Radiotherapy, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China; 2Imaging Center, Shijiazhuang First Hospital, Shijiazhuang 050011, China
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%PTV1 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.
Shen Wenbin,Gao Hongmei,Xu Jinrui et al. Preliminary analysis of recurrence-free survival after radical intensity-modulated radiotherapy combined with/without chemotherapy for upper cervical and thoracic esophageal cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(2): 143-148.
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