Long-Term Clinical Outcomes and Safety Analysis of Superficial Esophageal Cancer Patients Treated with Definitive or Adjuvant Radiotherapy

• Published in: Cancers Vol. 14; no. 14; p. 3423
• Main Authors: Lyu, Bo, Yin, Yutian, Zhao, Yilin, Yang, Xu, Gong, Jie, Zhang, Mai, Chai, Guangjin, Li, Zhaohui, Shi, Mei, Hui, Zhouguang, Zhao, Lina
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.07.2022; MDPI
• Subjects: Blood; Cancer; Cancer therapies; Chemoradiotherapy; Chi-square test; Endoscopy; Esophageal cancer; Esophagitis; Esophagus; Lymph nodes; Lymphatic system; Metastases; Metastasis; Myelosuppression; outcomes research; Patients; Radiation therapy; radiotherapy; Risk factors; Stricture; superficial esophageal cancer; Surgery; Survival analysis; Tomography; toxicities; Toxicity; Tumors; radiotherapy; toxicities; outcomes research; superficial esophageal cancer
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers14143423

(1) Background: The role of radiotherapy (RT) in superficial esophageal squamous cell cancer (ESCC) remains unclear. The objective of our study was to perform a detailed outcome and safety analysis of RT as a definitive or adjuvant treatment for T1N0M0 staged ESCC patients. (2) Methods: A total of 55 patients treated with endoscopic resection (ER) + RT/concurrent chemoradiotherapy (CCRT) or RT/CCRT from January 2011 to June 2021 were included in this study. Eighteen patients with risk factors received ER + RT/CCRT, and thirty-seven patients solely received RT/CCRT. Kaplan-Meier curves were used to calculate the clinical outcomes, and toxicities were scored. (3) Results: The median follow-up time was 51.9 months. The estimated 5-year local recurrence-free survival (LRFS) and overall survival (OS) were 88.9% and 94.4% in the ER + RT/CCRT group and 91.8% and 91.7% in the RT/CCRT group. The predominant failure pattern was in-field local failure (5.5%, 3/55), with one patient in the ER + RT/CCRT group and two patients in the RT/CCRT group. One patient (1.8%, 1/55) had lung metastasis in the RT/CCRT group. The most common toxicities were Grades 1-2 in all patients, including esophagitis (74.5%, 41/55), myelosuppression (49.1%, 27/55) and esophageal stricture after RT (27.3%, 15/55). Two patients (11.1%, 2/18) and four patients (10.8%, 4/37) had Grade 3 esophageal stricture after RT in the ER + RT/CCRT group and RT/CCRT group, respectively. No patients experienced a Grade 4 or higher toxicity, and there were no treatment-related deaths. (4) Conclusions: Definitive or adjuvant RT/CCRT is an effective treatment alternative for superficial ESCC patients with satisfactory clinical outcomes and acceptable toxicities.