Treatment Outcome of Neoadjuvant Chemoradiotherapy for Esophageal Squamous Cell Carcinoma in Our Institution

食道鱗狀上皮癌術前合併放射與化學治療的治療結果

張國楨(Kuo-Chen Chang) ； 劉文山(Wen-Shan Liu) ； 張慶雄(Ching-Hsiung Chang) ； 胡渝昌(Yu-Chang Hu) ； 陳建勳(Chien-Hsun Chen) ； 梁頌文(Chung-Man Leung)

《放射治療與腫瘤學》 20卷3期 (2013/09) Pp. 171-178

https://doi.org/10.6316/TRO/201320(3)171

摘要

Purpose: In this retrospective study, we evaluated the treatment outcome following neoadjuvant chemoradiotherapy for esophageal cancer and the impact of tumor regression and post operative nodal status.Materials and Methods: Sixty-four patients of esophageal cancer treated with neoadjuvant chemoradiotherapy from June, 1999 to April, 2011 were followed retrospectively. Tumor regression grade (TRG), post operative nodal status, pathologic stage, pattern of recurrence and overall survival (OS) of these patients were recorded and analyzed. Disease-free and overall survival rates were calculated with Kaplan-Meier method and group comparisons were based on the log-rank test. Cox regression analysis was the method applied when several factors were assessed simultaneously.Results: Median survival is 24.2 months (range, 3-92 months). Comparing TRG 1 with TRG 2-4, the OS was not significantly different (P = 0.549). When TRG1-2 was compared with TRG3-4, there was a trend of significant difference in OS (P = 0.089). The median survival was 23.6 months in the N- group, compared with 13.5 months in the N+ group (P ＜ 0.001). In univariate survival analysis, N+ (P ＜ 0.001) and vascular involvement (P = 0.041) significantly influence survival probabilities. N+ was significantly (P = 0.001) associated with distant metastasis and TRG 3-4 (P = 0.008) with locoregional recurrence. By multivariate analysis, only N+ significantly influence OS (P = 0.004) and vascular involvement (P = 0.658) was not significant.Conclusion: For those who are receiving neoadjuvant chemoradiotherapy, achieving node-negative status is a significant prognostic factor for the outcome. As for histomorphologic tumor regression, it has a less predictive factor.

關鍵字

食道癌 ； 術前同步放射與化療治療 ； 腫瘤減少程度

並列摘要

Purpose: In this retrospective study, we evaluated the treatment outcome following neoadjuvant chemoradiotherapy for esophageal cancer and the impact of tumor regression and post operative nodal status.Materials and Methods: Sixty-four patients of esophageal cancer treated with neoadjuvant chemoradiotherapy from June, 1999 to April, 2011 were followed retrospectively. Tumor regression grade (TRG), post operative nodal status, pathologic stage, pattern of recurrence and overall survival (OS) of these patients were recorded and analyzed. Disease-free and overall survival rates were calculated with Kaplan-Meier method and group comparisons were based on the log-rank test. Cox regression analysis was the method applied when several factors were assessed simultaneously.Results: Median survival is 24.2 months (range, 3-92 months). Comparing TRG 1 with TRG 2-4, the OS was not significantly different (P = 0.549). When TRG1-2 was compared with TRG3-4, there was a trend of significant difference in OS (P = 0.089). The median survival was 23.6 months in the N- group, compared with 13.5 months in the N+ group (P ＜ 0.001). In univariate survival analysis, N+ (P ＜ 0.001) and vascular involvement (P = 0.041) significantly influence survival probabilities. N+ was significantly (P = 0.001) associated with distant metastasis and TRG 3-4 (P = 0.008) with locoregional recurrence. By multivariate analysis, only N+ significantly influence OS (P = 0.004) and vascular involvement (P = 0.658) was not significant.Conclusion: For those who are receiving neoadjuvant chemoradiotherapy, achieving node-negative status is a significant prognostic factor for the outcome. As for histomorphologic tumor regression, it has a less predictive factor.

並列關鍵字

Esophageal cancer ； Neoadjuvant chemoradiotherapy ； Tumor regression grade