Outcomes of patients with stage IVA esophageal cancer (Japanese classification) treated with definitive chemoradiotherapy

Jpn J Radiol. 2013 Apr;31(4):270-6. doi: 10.1007/s11604-013-0180-1. Epub 2013 Feb 2.

Abstract

Purpose: To evaluate treatment outcomes of chemoradiotherapy for patients with stage IVA esophageal cancer and to estimate prognostic factors.

Materials and methods: Patients with stage IVA esophageal cancer treated with chemoradiotherapy between April 2003 and March 2009 were evaluated. Patients received concurrent chemoradiotherapy comprising cisplatin plus 5-fluorouracil and 61.2 Gy of radiotherapy. Therapeutic response, overall survival time, and toxicity were examined and statistical evaluation was performed.

Results: Ninety patients were treated using chemoradiotherapy. Among these, 71 patients (78.9 %) received the complete course of chemoradiotherapy. Seventeen patients (18.9 %) showed complete response, 64 patients (71.1 %) had partial response, 7 patients (7.8 %) experienced no change, and 2 patients (2.2 %) exhibited progressive disease. Mean duration of follow-up was 16.1 months (range 2-88 months). Median overall survival was 12.8 months. Two- and 3-year overall survival rates were 35.1 and 18.6 %, respectively. Severe hematological toxicities included Grade 3 leukopenia in 33 patients (36.7 %). Treatment-related death was estimated to have occurred in 7 patients. Performance status and body weight loss were identified as significant prognostic factors.

Conclusion: Our treatment outcomes appeared similar to those of previous studies that used chemoradiotherapy for advanced esophageal cancer. This treatment is useful for stage IVA esophageal cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Agents / administration & dosage
  • Chemoradiotherapy* / adverse effects
  • Chemoradiotherapy* / mortality
  • Cisplatin / administration & dosage
  • Esophageal Neoplasms / therapy*
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Radiotherapy Dosage
  • Treatment Outcome
  • Weight Loss

Substances

  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents
  • Cisplatin
  • Fluorouracil