Definitive radiochemotherapy in esophageal cancer - a single institution experience
, , , , , , and | Nov 20, 2019
About this article
Article Category: Research Article
Published Online: Nov 20, 2019
Page range: 480 - 487
Received: Mar 22, 2019
Accepted: Sep 20, 2019
DOI: https://doi.org/10.2478/raon-2019-0054
© 2019 Franc Anderluh, Miha Toplak, Vaneja Velenik, Irena Oblak, Ajra Secerov Ermenc, Ana Jeromen Peressutti, Jasna But-Hadzic, Marija Skoblar Vidmar, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
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Results of univariate analysis testing the impact of different parameters on survivals
| OS (p) | LRC (p) | DFS (p) | |
|---|---|---|---|
| Gender: | |||
| male (N = 45) | 0.16 | 0.46 | 0.63 |
| female (N = 10) | |||
| Age: | |||
| ≤ 62 years (N = 29) | 0.16 | 0.6 | 0.85 |
| > 62 years (N = 26) | |||
| WHO performance stage: | |||
| 0–1 (N = 50) | 0.99 | 0.78 | 0.95 |
| 2 (N = 5) | |||
| Risk factors: | |||
| none present (N = 19) | 0.67 | 0.24 | 0.23 |
| at least one present (N = 36) | |||
| Tumor localization: | |||
| upper third - cervical (N = 32) | 0.18 | 0.56 | 0.57 |
| middle third - intrathoracic (N = 23) | |||
| T stage: | |||
| T 1+2 (N = 8) | 0.38 | 0.76 | 0.37 |
| T 3+4 (N = 47) | |||
| N stage: | |||
| N0 (N = 20) | 0.79 | 0.22 | 0.42 |
| N+ (N = 35) | |||
| Treatment schedule: | |||
| definitive radiochemotherapy (N = 49) | 0.66 | 0.55 | 0.46 |
| TD on tumor: | |||
| ≤ 57.6 Gy (N = 35) | 0.61 | 0.52 | 0.79 |
| > 57.6 Gy (N = 20) |
Different chemotherapy regimens used
| Chemotherapy regimen used | N (%) |
|---|---|
| 5-FU in continuous 96 hours infusion + cisplatin | 41 (74.5) |
| Weekly cisplatin only during RT | 3 (5.5) |
| Paclitaxel + carboplatin | 2 (3.6) |
| 5-FU + carboplatin | 2 (3.6) |
| Induction TCF followed by weekly cisplatin during RT | 1 (1.8) |
| Induction 5-FU + cisplatin followed by weekly carboplatin during RT | 1 (1.8) |
| Induction paclitaxel + carboplatin followed by weekly carboplatin during RT | 1 (1.8) |
| Induction weekly cisplatin followed by weekly carboplatin during RT | 1 (1.8) |
| Induction paclitaxel + carboplatin followed by 5-FU + cisplatin during RT | 1 (1.8) |
| Induction capecitabine + cisplatin followed by weekly cisplatin during RT | 1 (1.8) |
| No chemotherapy given | 1 (1.8) |
Side effects of concomitant radiochemotherapy (according to EORTC Common Toxicity Criteria version 4)
| Side effect | Grade | |||
|---|---|---|---|---|
| 0 | 1 | 2 | 3 | |
| Esophagitis | 6 (10.9) | 21 (38.2) | 17 (30.9) | 10 (18.2) |
| Radiodermatitis | 35 (63.3) | 8 (14.5) | 7 (12.7) | 4 (7.3) |
| Nausea | 40 (72.7) | 9 (16.4) | 4 (7.3) | 1 (1.8) |
| Vomiting | 50 (90.9) | 1 (1.8) | 3 (5.5) | 0 |
| Neutropenia | 25 (45.5) | 8 (14.5) | 10 (18.2) | 12 (21.8) |
| Thrombocytopenia | 20 (36.4) | 21 (38.2) | 8 (14.5) | 6 (10.9) |
| Anemia | 6 (10.9) | 27 (49.1) | 21 (38.2) | 1 (1.8) |
Patients’ and tumors’ characteristics
| N (%) | |
|---|---|
| Gender | |
| male | 45 (81.8) |
| female | 10 (18.2) |
| Age at diagnosis (years) | mean: 62 (SD |
| WHO performance stage | |
| 0 | 24 (43.6) |
| 1 | 26 (47.3) |
| 2 | 5 (9.1) |
| Risk factors | |
| none | 13 (23.6) |
| active or ex-smokers | 31 (56.4) |
| gastroesophageal reflux | 2 (3.6) |
| gastroesophageal reflux and smoking | 3 (5.5) |
| unknown | 6 (10.9) |
| T stage | |
| T X | 1 (1.8) |
| T 1 | 1 (1.8) |
| T 2 | 6 (10.9) |
| T 3 | 36 (65.5) |
| T 4 | 11 (20) |
| N stage | |
| N 0 | 20 (36.4) |
| N 1 | 20 (36.4) |
| N 2 | 12 (21.8) |
| N 3 | 3 (5.5) |
| Histology | |
| squamous cell cancer | 53 (96.4) |
| adenocarcinoma | 1 (1.8) |
| verified carcinoma, unspecified | 1 (1.8) |
| Grade | |
| G 1 | 3 (5.5) |
| G 2 | 28 (50.9) |
| G 3 | 12 (21.8) |
| unknown or not specified | 12 (21.8) |
| Upper border of the tumor | |
| ≤ 18 cm from the incisors | 32 (58.2) |
| 18–32 cm from the incisors | 23 (41.8) |
Median, two- and five years survivals
| OS | LRC | DFS | |
|---|---|---|---|
| Median | 20.5 months | 16.6 months | 12.9 months |
| (95% CI 8.2–32.8) | (95% CI 7.3–26) | (95% CI 9.8-16.1) | |
| 2-year | 47% | 43.7% | 32.1% |
| 5-year | 19.4% | 41% | 11.5% |