DOI QR코드

DOI QR Code

Survival in Patients Treated with Definitive Chemo-Radiotherapy for Non-Metastatic Esophageal Cancer in North-West Iran

  • Mirinezhad, Seyed Kazem ;
  • Somi, Mohammad Hossein ;
  • Seyednezhad, Farshad ;
  • Jangjoo, Amir Ghasemi ;
  • Ghojazadeh, Morteza ;
  • Mohammadzadeh, Mohammad ;
  • Naseri, Ali Reza ;
  • Nasiri, Behnam
  • Published : 2013.03.30

Abstract

Background: Areas of Iran have among the highest incidences of esophageal cancer in the world. Definitive chemo-radiotherapy (DCRT) is used for locally advanced esophageal cancer and for inoperable tumors asan alternative to surgical treatment. Materials and Methods: This retrospective study was conducted in North-West Iran 2006-2011, including 267 consecutive patients with non-metastatic esophageal cancer. Eligible inoperable patients were treated with DCRT or definitive radiotherapy (DRT) alone. Radiotherapy (RT) was delivered at 1.8-2 Gy/day for five consecutive days in a given week. Chemotherapy (CT) consisted of cisplatin and 5-fluorouracil. Results: The median survival was 12.7 months with 1, 3 and 5 year survival rates of 55%, 18% and 11%, respectively. On univariate analysis, relations with age at diagnosis (p=0.015), N-stage (p=0.04), total dose of RT (p=0.001), fraction (p<0.001), Gap status (p=0.025), chemotherapeutic regimens (P=0.027), and 5-Fu $Mg/m^2$ (P=0.004) were apparent. Comparing DCRT to DRT, there was a significant difference in survival. Multivariate analysis was performed for comparison between DCRT and DRT showed significant association with age group ${\geq}65$ to <65 (P=0.02; OR: 1.46), the total RT dose (Gy) ${\geq}50$ to <50 (P=0.01; OR: 0.65) and the fraction group ${\geq}25$ to <25 (P=<0.001; OR: 0.54). Conclusions: The survival rates of esophageal cancer treated with DCRT in North West of Iran is poor; therefore, early detection and improved treatment methods, with clinical trials are a high priority.

Keywords

Survival;esophageal cancer;definitive chemo radiotherapy;North-West Iran

References

  1. Aghcheli K, Marjani A, Nasrollahzadeh D, et al (2011). Prognostic factors for esophageal squamous cell carcinoma-a population-based study in Golestan province, Iran, a High Incidence Area. PLoS ONE, 6, 1-7.
  2. Byun SJ, Kim JH, Kim OB, et al (2011). Concurrent chemoradiotherapy in locally advanced esophageal cancer. Society for Therapeutic Radiology and Oncology, 29, 20-7. https://doi.org/10.3857/jkstro.2011.29.1.20
  3. Ghadimi M, Rasouli M, Mahmoodi M , et al (2011). Prognostic factors for the survival of patients with esophageal cancer in Northern Iran. J Res Med Sci, 16, 1261-72.
  4. Gwynne S, Hurty C, Evans M, et al (2011). Definitive chemoradiation for oesophageal cancer - a standard of care in patients with non-metastatic oesophageal cancer. Clinical Oncology, 23, 182-8. https://doi.org/10.1016/j.clon.2010.12.001
  5. Mirinezhad SK, SomiMH, Ghasemi JA, et al (2012). Survival rate and prognostic factors of esophageal cancer in east Azerbaijan province, north-west of Iran. Asian Pac J Cancer Prev, 13, 3451-4. https://doi.org/10.7314/APJCP.2012.13.7.3451
  6. Motoori M, YanoM, Ishihara R, et al (2012).Comparison between radical esophagectomy and definitive chemoradiotherapy in patients with clinical T1bN0M0 esophageal cancer. Ann Surg Oncol, 19, 2135-41. https://doi.org/10.1245/s10434-012-2231-8
  7. Sadjadi A, Marjani H, Semnani S, et al (2010). Esophageal cancer in Iran: A review. Middle East J Cancer, 1, 5-14.
  8. Semrau R, Herzog SL, Vallbohmer D, et al (2012). Prognostic factors in definitive radiochemotherapy of advanced inoperable esophageal cancer. Dis Esophagus, 25, 545-54. https://doi.org/10.1111/j.1442-2050.2011.01286.x

Cited by

  1. Patterns of Failure after Radical Surgery among Patients with Thoracic Esophageal Squamous Cell Carcinoma: Implications for the Clinical Target Volume Design of Postoperative Radiotherapy vol.9, pp.5, 2014, https://doi.org/10.1371/journal.pone.0097225
  2. A Meta-Analysis of Concurrent Chemoradiotherapy for Advanced Esophageal Cancer vol.10, pp.6, 2015, https://doi.org/10.1371/journal.pone.0128616
  3. Feasibility and Efficacy of Concurrent Chemoradiotherapy in Elderly Patients with Esophageal Squamous Cell Carcinoma: a Respective Study of 116 Cases from a Single Institution vol.16, pp.4, 2015, https://doi.org/10.7314/APJCP.2015.16.4.1463