| Yu Bo,Wang Jianlin,Liu Huilan,et al.Analysis of outcomes and prognostic factors in 373 esophageal cancer patients treated with three-dimensional conformal radiotherapy[J].Chinese Journal of Radiological Medicine and Protection,2018,38(3):174-179 |
| Analysis of outcomes and prognostic factors in 373 esophageal cancer patients treated with three-dimensional conformal radiotherapy |
| Received:October 24, 2017 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.03.003 |
| KeyWords:Esophageal cancer Radiotherapy Three-dimensional conformal Intensity-modulated Prognosis |
| FundProject:国家自然科学基金（11705095） |
| Author Name | Affiliation | E-mail | | Yu Bo | Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China | | | Wang Jianlin | Department of Radiotherapy, Changzhou Second People's Hospital, Affiliated Hospital of Nanjing Medical University, Changzhou 213003, China | | | Liu Huilan | Department of Tumor, Taizhou People's Hospital, Taizhou 225300, China | | | Dai Shengbin | Department of Tumor, Taizhou People's Hospital, Taizhou 225300, China | | | Sha Sha | Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China | | | Wang Qiong | Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China | | | Mao Weidong | Department of Radiotherapy, Jiangyin People's Hospital, Jiangyin 214400, China | | | Zhou Juying | Department of Radiotherapy, First Affiliated Hospital of Soochow University, Suzhou 215006, China | | | Wang Lili | Department of Radiotherapy, First Affiliated Hospital of Soochow University, Suzhou 215006, China | | | Wang Jian | Department of Radiotherapy, Changzhou Second People's Hospital, Affiliated Hospital of Nanjing Medical University, Changzhou 213003, China | 1627879372@qq.com |
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| Abstract:: |
| Objective To observe the long-term prognosis and analyze the predictive factors of esophageal cancer patients treated with three-dimensional radiotherapy. Methods A total of 373 patients with esophageal squamous carcinoma who received three-dimensional radiotherapy were retrospectively enrolled in this study. Among these, 231 cases received three dimensional conformal radiotherapy (3D-CRT) and the other 142 received intensity modulated radiotherapy(IMRT); 202 cases received radiotherapy alone, and the other 171 received chemoradiotherapy; 249 cases received involved-field irradiation(IFI), and the other 124 received elective nodal irradiation(ENI); 60 cases received a total radiation dose of 50-60 Gy, and the other 313 received 60-70 Gy. Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS). The Logrank single factor analysis and Cox multivariate analysis were used to evaluate predictive factors of PFS and OS. Results The 1-, 3-, 5-year OS and PFS were 69.4%, 33.7%, 22.9% and 63.8%, 32.8%, 22.4%, respectively. The median OS and PFS were 22.7 months (95%CI 18.6-25.4 months) and 19.2 months (95%CI 16.7-21.3 months) respectively. Univariate analysis showed that age, gender, tumor location, three-dimensional technology (3D-CRT vs. IMRT), chemotherapy, prophylactic irradiation to lymphatic drainage area and irradiation dose did not influence OS and PFS (P>0.05). T-stage, N-stage, TNM-stage and gross tumor volume (GTV) were significantly correlated to OS and PFS (χ2=5.836-14.526, P<0.05). The multivariate analysis showed that N-stage and GTV were independent predictive factors of OS and PFS (χ2=5.345-12.216, P<0.05). The OS and PFS of patients with two fields of lymph node metastases were worse than those with only one lymph node field metastasis (χ2=4.467,4.169, P<0.05). Conclusions The long-term efficacy for esophageal cancer patients could be significantly improved through 3D-CRT technology. N-stage and tumor volume were independent prognostic factors of OS and DFS. The number of lymph node metastasis field is significantly related to prognosis. |
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