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Erschienen in:
29.03.2017 | Original Article
The treatment results of definitive radiotherapy for cervical esophageal cancer: a single-institution experience
Erschienen in: Esophagus | Ausgabe 3/2017
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Background
Cervical esophageal cancer (CEC) is an uncommon disease. Thus, the clinical data from CEC patients have not been sufficient to establish a standard treatment.
Methods
Forty-six CEC patients who received definitive radiotherapy at our center from January 2003 to December 2014 were enrolled in this retrospective study. The stages of the patients according to the UICC 2002 staging system were as follows: stage I, n = 5; stage IIA + IIB, n = 3; and stage III, n = 38. The median radiation dose was 60 Gy. Thirty-nine patients (84.8%) received concurrent chemotherapy.
Results
The 3-year overall survival rate of the 46 patients was 45.4%. The 3-year laryngectomy-free survival rates of non-T4 (n = 20) and T4 patients (n = 26) were 57.8 and 23.6%, respectively; there was a significant difference (p = 0.010). Among the 35 patients who survived for >1 year after treatment, 29 (82.8%) had mild or no dysphagia and could eat solid foods. Among the 11 patients who died at more than 2 years after treatment, 6 (54.5%) died from distant metastasis. Although the number of cases is small, the results of the log-rank tests for various factors suggest that the performance status, tumor progression (TNM stage, T factor, and N factor), tumor response to definitive radiotherapy, and tumor response to induction chemotherapy might affect the prognosis.
Conclusions
Definitive radiotherapy is a promising organ-preserving treatment for CEC, especially in patients with non-T4 disease. However, new treatment strategies will be required to improve the outcomes of patients with advanced CEC, and confirmatory prospective clinical trials are required.