Clinical efficacy and failure pattern in patients with cervical esophageal cancer treated with definitive chemoradiotherapy

Abstract

Background: Data on cervical esophageal cancer (CEC) based on modern radiotherapy technique are rare. We aimed to analyze the clinical efficacy and failure pattern of patients with CEC who underwent definitive chemoradiotherapy.

Methods: Between February 2002 and October 2013, 102 patients with CEC treated with definitive chemoradiotherapy were retrospectively analyzed. All patients received concurrent platinum-based chemotherapy with conformal radiotherapy (50-70 Gy in 25-35 fractions, 5 fractions per week over 5-7 weeks). Overall survival (OS), progression-free survival (PFS) and loco-regional failure-free survival (LRFFS) were calculated.

Results: The 3-year OS, PFS and LRFFS rates for the entire sample were 39.3%, 33.6% and 35.3%, respectively. During follow-up, 32, 26, and 41 patients had developed local, regional, and distant failure, respectively. Sex and hoarseness were independent prognostic indicators for OS (P=0.011, P<0.001; respectively) and PFS (P=0.008, P=0.001; respectively). Hoarseness was the only independent prognostic factor for LRFFS (P=0.002).

Conclusions: Distant metastasis was the most common failure pattern in CEC patients undergoing definitive chemoradiotherapy. Hoarseness was an independent prognostic factor for OS, PFS, and LRFFS.

Keywords: Cervical esophageal cancer; Chemoradiotherapy; Failure pattern; Prognosis; Prognostic factor.