| Li Qiaofang,Li Shuguang,Xu Jinrui,Deng Wenzhao,Song Chunyang,Wang Xuan,Zhu Shuchai.Survival analysis of patients with non-surgical esophageal carcinoma receiving intensity-modulated radiotherapy (IMRT) alone[J].Chinese Journal of Radiological Medicine and Protection,2020,40(8):600-605 |
| Survival analysis of patients with non-surgical esophageal carcinoma receiving intensity-modulated radiotherapy (IMRT) alone |
| Received:October 09, 2019 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.08.005 |
| KeyWords:Esophageal carcinoma Elective nodal irradiation (ENI) Involved-field irradiation (IFI) Intensity-modulated radiotherapy Prognostic factors |
| FundProject: |
| Author Name | Affiliation | E-mail | | Li Qiaofang | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Li Shuguang | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Xu Jinrui | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Deng Wenzhao | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Song Chunyang | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Wang Xuan | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhu Shuchai | Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | sczhu1965@163.com |
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| Abstract:: |
| Objective To evaluate the efficacy of target area of radical radiotherapy for inoperable esophageal carcinoma patients treated with intensity-modulated radiotherapy (IMRT). Methods A retrospective analysis was performed on the clinical data of 564 Ⅰ-Ⅳ non-surgical esophageal cancer who received definitive intensity-modulated radiotherapy alone in our hospital from 2006 to 2015. Propensity score matching (PSM) was used to identify well-balanced patients for comparison. The Kaplan-Meier method was used to calculate local-regional failure-free survival (LRFFS), progression-free survival (PFS), overall survival (OS) rates and univariate analysis. The multivariate analysis of prognostic factors were tested by COX proportional hazard model. Results The last follow-up time was December 2018, the median follow-up time was 99.7 (95% CI:77.5-122.1) months. Follow-up rate was 95.9%. For the 564 patients, the 1-, 3-, 5-year LRFFS were 61.5%, 26.5%, 14.3%, PFS were 56.7%, 25.0%, 13.4%, OS were 73.0%, 31.1%, 16.8%. After PSM, for the elective-nodal irradiation (ENI) (n=141) and involved-nodal irradiation (IFI) (n=141) groups, the 1-, 3-, 5-year LRFFS were 68.8%, 34.2%, 19.1% vs. 65.2%, 32.1%, 17.9% (P>0.05), PFS were 63.1%, 31.0%, 16.6% vs. 60.3%, 29.3%, 16.6% (P>0.05), OS were 80.9%, 41.5%, 23.3% vs. 80.1%, 35.0%, 20.2% (P>0.05). In multivariate analysis, tumor volume ≤ 37 cm3 and Ⅰ+Ⅱ stage were independent factors for LRFFS, PFS and OS. Subgroup analysis showed that there were no significant differences in the survival rates between the ENI group and IFI group (P>0.05). Comparing to the IFI group, ENI reduced the local-regional failure rate (P=0.048). Conclusions Using intensity-modulated radiation therapy alone for inoperable esophageal carcinoma, ENI can significantly reduce the local-regional failure rate, but not improve survival rates compared to the IFI. |
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