TY - JOUR
T1 - Patterns of failure and clinical outcomes of definitive radiotherapy for cervical esophageal cancer
AU - Zhao, Lina
AU - Zhou, Yongchun
AU - Mu, Yunfeng
AU - Chai, Guangjin
AU - Xiao, Feng
AU - Tan, Lina
AU - Lin, Steven H.
AU - Shi, Mei
N1 - Funding Information:
This work was supported by National Natural Science Foundation of China Grants 81101689 and 81372421.
PY - 2017
Y1 - 2017
N2 - Purpose: Because of the scarcity of cervical esophageal cancer (CEC), data for this disease entity is limited. We aim to evaluate the outcomes, prognostic factors and failure patterns of CEC treated by contemporary radiotherapy (RT). Methods: We retrospectively analyzed 86 CEC patients consecutively treated between 2007 and 2015 by definitive RT with or without concurrent chemotherapy. RT was mainly delivered with Intensity Modulated Irradiation Therapy (IMRT) or Volumetric-Modulated Arc Therapy (VMAT). Statistical analyses were performed on survival, prognostic factors and failure patterns. Results: The median follow-up time was 19.4 months. The 3-year overall survival (OS), local regional failure free survival (LRFFS), distant metastatic free survival (DMFS), and progression free survival (PFS) were 53.6%, 57.9%, 81.5% and 41.5%, respectively. Independent predictors for poorer OS were N stage, hoarseness and recurrent laryngeal nerve lymph node (RLN) involvement, and predictors for LRFFS were N stage and EQD2 (equivalent dose in 2 Gy fraction) to gross tumor volume (GTV), with ≥ 66Gy achieving local control of 94.7%. Patients receiving elective nodal irradiation (ENI) had better nodal regional control than those receiving involved field irradiation (IFI). 31 (36%) patients had treatment failure and 15 (17.4%), 8 (9.3%) and 14 (16.2%) patients had local, regional, and distant failure, respectively. 86.7% (13/15) local failures were within GTV, and supraclavicular region (62.5%, 5/8) was the most common regional failure site. No severe toxicities were observed. Conclusions: Our results seem to indicate that good locoregional control might be achieved for CEC with adequate radiation dose and treatment planning approaches.
AB - Purpose: Because of the scarcity of cervical esophageal cancer (CEC), data for this disease entity is limited. We aim to evaluate the outcomes, prognostic factors and failure patterns of CEC treated by contemporary radiotherapy (RT). Methods: We retrospectively analyzed 86 CEC patients consecutively treated between 2007 and 2015 by definitive RT with or without concurrent chemotherapy. RT was mainly delivered with Intensity Modulated Irradiation Therapy (IMRT) or Volumetric-Modulated Arc Therapy (VMAT). Statistical analyses were performed on survival, prognostic factors and failure patterns. Results: The median follow-up time was 19.4 months. The 3-year overall survival (OS), local regional failure free survival (LRFFS), distant metastatic free survival (DMFS), and progression free survival (PFS) were 53.6%, 57.9%, 81.5% and 41.5%, respectively. Independent predictors for poorer OS were N stage, hoarseness and recurrent laryngeal nerve lymph node (RLN) involvement, and predictors for LRFFS were N stage and EQD2 (equivalent dose in 2 Gy fraction) to gross tumor volume (GTV), with ≥ 66Gy achieving local control of 94.7%. Patients receiving elective nodal irradiation (ENI) had better nodal regional control than those receiving involved field irradiation (IFI). 31 (36%) patients had treatment failure and 15 (17.4%), 8 (9.3%) and 14 (16.2%) patients had local, regional, and distant failure, respectively. 86.7% (13/15) local failures were within GTV, and supraclavicular region (62.5%, 5/8) was the most common regional failure site. No severe toxicities were observed. Conclusions: Our results seem to indicate that good locoregional control might be achieved for CEC with adequate radiation dose and treatment planning approaches.
KW - Cervical esophageal cancer
KW - Definitive radiotherapy
KW - Failure pattern
KW - Prognostic factor
KW - Prophylactic irradiation
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U2 - 10.18632/oncotarget.15665
DO - 10.18632/oncotarget.15665
M3 - Article
C2 - 28423530
AN - SCOPUS:85016431543
SN - 1949-2553
VL - 8
SP - 21852
EP - 21860
JO - Oncotarget
JF - Oncotarget
IS - 13
ER -