Long-term results of chemoradiotherapy for stage II-III thoracic esophageal cancer in a single institution after 2000 -with a focus on comparison of three protocols-

摘要

Background To evaluate the long-term results of chemoradiotherapy (CRT) for stage II-III thoracic esophageal cancer mainly by comparing results of three protocols retrospectively. Methods Between 2000 and 2012, 298 patients with stage II-III thoracic esophageal cancer underwent CRT. Patients in Group A received two cycles of cisplatin (CDDP) at 70?mg/m2 (day 1 and 29) and 5-fluorouracil (5-FU) at 700?mg/m2/24?h (day 1–4 and 29–32) with radiotherapy (RT) of 60?Gy without a break. Patients in Group B received two cycles of CDDP at 40?mg/m2 (day 1, 8, 36 and 43) and 5-FU at 400?mg/m2/24?h (day 1–5, 8–12, 36–40 and 43–47) with RT of 60?Gy with a 2-week break. Patients in Group C received two cycles of nedaplatin at 70?mg/m2 (day 1 and 29) and 5-FU at 500?mg/m2/24?h (day 1–4 and 29–32) with RT of 60–70?Gy without a break. Differences in prognostic factors between the groups were analyzed by univariate and multivariate analyses. Results The 5-year overall survival rates for patients in Group A, Group B and Group C were 52.4, 45.2 and 37.2?%, respectively. The 5-year overall survival rates for patients in Stage II, Stage III (non-T4) and Stage III (T4) were 64.0, 40.1 and 22.5?%, respectively. The 5-year overall survival rates for patients who received 1?cycle and 2?cycles of concomitant chemotherapy were 27.9 and 46.0?%, respectively. In univariate analysis, stage, performance status and number of concomitant chemotherapy cycles were significant prognostic factors ( p Conclusions The protocol used in Group A may be an effective protocol of CRT for esophageal cancer. It may be important to complete the scheduled concomitant chemotherapy with the appropriate intensity of CRT.