Shen Wenbin,Gao Hongmei,Zhu Shuchai,et al.Analysis of the failure patterns for esophageal cancer patients after radiotherapy with complete remission[J].Chinese Journal of Radiological Medicine and Protection,2014,34(3):206-210
Analysis of the failure patterns for esophageal cancer patients after radiotherapy with complete remission
Received:April 17, 2013  
DOI:10.3760/cma.j.issn.0254-5098.2014.03.012
KeyWords:Esophageal squamous cell carcinoma  Three-dimensional conformal radiotherapy  Complete remission  Failure pattern
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Author NameAffiliationE-mail
Shen Wenbin Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Gao Hongmei 石家庄市第一医院放射科  
Zhu Shuchai Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China sczhu1965@163.com 
Cao Yankun Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Li Youmei Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Su Jingwei Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Liu Zhikun Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Li Juan Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
Li Shuguang Department of Radiation Oncology, The Forth Hospital, Hebei Medical University, Shijiazhuang 050011, China  
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Abstract::
      Objective To investigate the failure patterns for esophageal squamous cell carcinoma (ESCC) after radiotherapy and the influencing factors of recent efficacy. Methods 260 ESCC patients underwent radical radiotherapy and follow-up of 34.1 (6.2-105.2) months. The efficacy was observed to find locoregional recurrence and distant metastasis. Results Out of the 260 patients, 91 achieved complete remission (CR)(35.0%), 158(60.8%)achieved partial remission (PR),and 11(4.2%) achieved no remission (NR). Univariate analysis showed that gender(χ2=7.647,P<0.05), T stage(χ2=33.548,P<0.05), N stage(χ2=13.365,P<0.05), TNM stage(χ2=27.792,P<0.05), length of tumor(χ2=20.851,P<0.05), and gross tumor volume (GTV)(χ2=41.772,P<0.05)were the influencing factors for the recent efficacy. Locoregional recurrence was recognized in 75 patients, 66 patients showed distant metastasis alone, and locoregional recurrence accompanied with distant metastasis was observed in 16 patients. The overall survival rate of the recurrence/metastasis patients was significantly lower than that of the patients without metastasis/recurrence (χ2=23.330, 29.35,P<0.05). The recurrence/metastasis rate of the CR patients was significantly lower than that of the PR and NR patients respectively(χ2=11.248,20.301,P<0.05). The overall survival rate, local control rate, distant metastasis free survival rate, and disease-free survival rate of the CR patients were all significantly higher than those of the PR and NR patients respectively(χ2=83.080,41.340,72.640,40.010,P<0.05). Multivariate analysis showed that clinical T stage, clinical N stage, and recent curative effect were the independent influencing factors for the EC patients(HR=1.197, 2.309, 2.149,P<0.05). Conclusions Recent efficacy is the major influencing factor of the prognosis of ESCC, affecting the long-term survival of the patients after treatment, and closely related to the recurrence/metastasis as well. The prognosis of the CR patients is significantly better than that of both PR and NR patients.
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