Abstract：Objective To investigate the efficacy of three-dimensional conformal radiotherapy (3DCRT)±chemotherapy in esophageal cancer patients with tracheoesophageal groove lymph node (TGLN) metastasis. Methods A retrospective analysis was performed on 95 eligible esophageal cancer patients with TGLN metastasis from 2003 to 2010 to investigate the treatment outcome, prognostic factors, failure mode, etc. All patients received radiotherapy at 54-68 Gy/27-34 fractions within 5-7 weeks, and 38 of them also received cisplatin-based chemotherapy (concurrent chemoradiotherapy in 14 patients and 24 in sequential chemoradiotherapy). The Kaplan-Meier method was used to calculate survival rates, and the Cox regression model was used for multivariate prognostic analysis. Results The follow-up rate was 100%. After treatment, the overall response rate was 94% for esophageal lesions and 100% for metastatic lymph node lesions. The 1-, 2-, and 3-year overall survival rates were 52.5%, 31.6%, and 23.8%, respectively, and the median survival time was 13 months. Multivariate analysis showed that presence or absence of back/chest pain before treatment (P=0.041), the length of lesion (P=0.002), and the short-term outcome of esophageal lesion (P=0.000) were independent prognostic factors. In all patients, 18 had simple esophageal recurrence, 4 had simple lymph node metastasis or recurrence, 5 had esophageal recurrence with lymph node metastasis/recurrence, 28 had simple distant metastasis, 4 had esophageal recurrence with distant metastasis, 3 had distant metastasis with lymph node metastasis/recurrence, and 2had esophageal recurrence with lymph node metastasis/recurrence with distant metastasis. Conclusions 3DCRT±chemotherapy is safe for esophageal cancer patients with TGLN metastasis, but its efficacy needs to be further improved. The independent prognostic factors mostly correlate with esophageal lesion for these patients.
Shen Wenbin,Gao Hongmei,Zhu Shuchai et al. Efficacy of three-dimensional radiotherapy±chemotherapy in 95 esophageal cancer patients with tracheoesophageal groove lymph node metastasis[J]. Chinese Journal of Radiation Oncology, 2015, 24(1): 36-39.
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