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Radio(chemo)therapy for locally advanced squamous cell carcinoma of the esophagus : Long-term outcome.
[esophageal squamous cell carcinoma]
The
purpose
of
this
work
is
to
report
the
long
-term
outcomes
of
three
-dimensional
conformal
radio
(
chemo
)
therapy
in
the
curative
management
of
esophageal
squamous
cell
carcinoma
(
ESCC
)
.
A
retrospective
analysis
of
patients
treated
with
radio
(
chemo
)
therapy
between
1988
and
2011
at
Klinikum
rechts
der
Isar
,
Technische
Universität
München
was
performed
.
In
all
,
168
patients
received
radio
(
chemo
)
therapy
for
ESCC
in
curative
intention
.
The
median
follow-up
time
was
91
months
(
range
1
-
212
months
)
.
There
were
128
men
and
40
women
with
a
median
age
of
63
years
.
Selection
criteria
for
radio
(
chemo
)
therapy
were
unfit
for
surgery
and
/
or
unresectable
primary
tumor
(
n
=
146
,
87
%
)
or
patients
'
choice
(
n
=
22
,
13
%
)
.
The
majority
of
the
patients
received
a
combination
of
cisplatin
and
5
-
fluorouracil
chemotherapy
with
54
Gy
in
30
fractions
of
radiotherapy
.
The
median
overall
survival
(
OS
)
was
20
months
(
95
%
confidence
interval
17
-
23
months
)
.
The
OS
at
2
and
5
years
for
the
whole
cohort
was
41
±
4
%
and
22
±
3
%
,
respectively
.
Forty
patients
(
24
%
)
suffered
an
in
-field
recurrence
.
The
most
common
acute
nonhematologic
toxicity
>
grade
2
was
dysphagia
in
35
%
of
the
patients
.
Acute
hematologic
toxicity
>
grade
2
was
recorded
in
14
%
of
the
patients
.
There
was
no
grade
5
toxicity
observed
during
the
study
.
Poor
ECOG
performance
status
(
0
-
1
vs
.
2
-
3
,
HR
=
1
.
70
,
p
=
0
.
002
)
and
weight
loss
≥
10
%
before
the
start
of
therapy
(
HR
=
1
.
99
,
p
=
0
.
001
)
were
among
the
factors
significantly
associated
with
poor
OS
in
multivariate
analysis
.
Three
-dimensional
conformal
definitive
radio
(
chemo
)
therapy
is
well
tolerated
and
leads
to
long
-term
survival
in
more
than
20
%
of
patients
with
advanced
disease
and
/
or
contraindication
to
surgery
.
However
,
24
%
in
-field
recurrence
remains
a
major
concern
.
Prospective
trials
are
warranted
to
assess
if
a
well-tailored
conformal
radiochemotherapy
can
improve
the
local
control
and
obviate
the
need
for
surgical
resection
in
patients
with
good
general
condition
and
potentially
resectable
tumors
.
