Stage III Esophageal Squamous Cell Carcinoma Patients With Three-Dimensional Conformal or Intensity-Modulated Radiotherapy: A Multicenter Retrospective Study

• Published in: Frontiers in oncology Vol. 10; p. 580450
• Main Authors: Qin, Qin, Ge, Xiaolin, Wang, Xin, Wang, Lan, Li, Chen, Chen, Junqiang, Wang, Xiaomin, Zhao, Yidian, Zhang, Wencheng, Wang, Ping, Pang, Qingsong, Zhang, Kaixian, Li, Ling, Hu, Miaomiao, Hao, Chongli, Li, Gaofeng, Xu, Yonggang, Qiao, Xueying, Zhou, Zhiguo, Zhu, Shuchai, Shen, Wenbin, Wang, Yati, Lu, Na, Liu, Miaoling, Qie, Shuai, Han, Chun, Xiao, Zefen, Sun, Xinchen
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 06.10.2020
• Subjects: esophageal squamous cell carcinoma; intensity-modulated radiotherapy; Oncology; prognostic factor; survival; three dimensional conformal radiotherapy; esophageal squamous cell carcinoma; intensity-modulated radiotherapy; three dimensional conformal radiotherapy; prognostic factor; survival
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2020.580450

To evaluate long-term outcome and prognostic factors of stage III esophageal cancer after definitive radiotherapy using three dimensional conformal radiotherapy (3DCRT) or intensity-modulated radiotherapy (IMRT) techniques. Patients with T3N1M0/T4N0-1M0 esophageal squamous cell carcinoma (ESCC) treated with definitive radiotherapy from 2002 to 2016 in 10 Chinese medical centers were retrospectively analyzed. Overall survival (OS) and progression-free survival (PFS) rates were calculated. Prognostic factors were analyzed by Log-rank test and multivariable Cox model. Survival data of 1,450 patients were retrospectively collected. With a median follow-up time of 65.9 months, 1-, 3-, and 5-year OS rates were 69.3, 36.7, and 27.7%, respectively, and PFS rates were 58.6, 32.7, and 27.4%, respectively. Univariable analyses showed that gender, age, lesion location, lesion length, largest tumor diameter, lymph node metastasis, gross tumor volume, EQD2, short-term response, and concurrent chemotherapy were prognostic factors for OS. Multivariable analyses showed that lesion location, T-classification, GTV size, EQD2, and short-term response to RT were independent prognostic factors for OS, and tumor diameter, GTV size, and short-term response were independent prognostic factors for PFS. This study demonstrated that definitive radiotherapy using 3DCRT and IMRT provides promising outcomes for locally advanced ESCC.