Three-dimensional Conformal Radiotherapy For Esophageal Cancer: Analysis Of Treatment Results And Prognostic Factors

Objective: To evaluate the efficacy of 3D conformal radiotherapy for esophagealcarcinoma and identify prognostic factors in this patient group.Methods: One hundred and twenty five unresectable or inoperable esophageal cancerpatients were treated with 3D conformal radiotherapy in our institute from May 2002 to Jun2005. Their clinical data were analyzed retrospectively.Results: 1. The overall 1, 2, 3, and 4-year survival rates were 50.4%, 31.4%, 28.8%,and 26.6%, respectively. Median survival time was 13 months. Patients with stageâ… -â…¢diseases had a survival rate of 68.1%, 37.8%, an 34.4% at 1-y, 3-y, and 4-y, respectively.Median survival time for stageâ… -â…¢andâ…£diseases were 15.3 months and 9.5 months,respectively(P=0.0103). In patients group that has stageâ… -â…¢diseases and lesion lengthno more than 8.0 cm, the 1-, 3-, and 4-year survival rates were 60.7%, 41.3%, and 36.7%,respectively. 2. Local control rates for the whole group were 64.4%, 51.8%, and 51.8% at1-year, 3-year, and 4-year, respectively. Univariate analysis revealed that lesion located incervical esophagus, absence of perforation sign, short lesion length, no distant metastasis,early TNM stage, no local recurrence, and whole course of conformal radiotherapy wereassociated with better survival significantly. Multivariate analysis confirmed that lesionlocated in cervical esophagus, absence of perforation sign, early TNM stage, and no localrecurrence were independent prognostic factor for survival.Conclusion: Three-dimensional conformal radiotherapy is effective for esophagealcarcinomas in terms of survival and local control. Further improvement could be achievedwith multi-modality treatment. Lesion located in cervical esophagus, absence of perforationsign, early TNM stage, and no local recurrence were independent prognostic factor forsurvival.