title: Multivariate analysis of treatment outcome in patients with esophageal carcinoma treated with definitive radiotherapy.
abstract: To evaluate patient characteristics and treatment factors influencing outcome of patients treated with definitive radiotherapy, we performed retrospective analysis. From 1983 to 2000, 154 patients who were diagnosed as esophageal carcinoma without distant metastasis received definitive radiotherapy with (N = 90) or without (N = 64) systemic chemotherapy. One hundred forty-two males and 12 females were entered in the analysis. Thirty-four patients received an additional boost of intracavitary brachytherapy (ICBT). The median patient age was 68 years (range: 46-86). Disease stage was distributed as stage I, II, III, and IV for 33, 42, 33, and 45 patients, respectively. External beam radiotherapy was prescribed with a median 63 Gy (range: 38-77.8 Gy). The 2- and 5-year overall survival (OAS) and local control (LC) rates were 40.8/18.4% and 48.6/28.9%, respectively. In uni-/multivariate analyses, significant prognostic factors of OAS proved to be advanced T stage, absence of ICBT, and age less than 65 years. As for LC, adverse prognostic factors of uni/multivariate analysis were advanced T stage and poor performance status. The pretreatment T stage showed the most powerful influence on both survival and LC. Combination use of ICBT is proven to refine treatment outcome, although eligible criteria should be decided by a prospective study.
authors.affiliation: Department of Radiation Oncology, Aichi Cancer Center, Aichi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kodaira
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Fuwa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Itoh
authors.forename: Minoru
authors.initials: M
authors.lastname: Kamata
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Furutani
authors.forename: Syunzo
authors.initials: S
authors.lastname: Hatooka
authors.forename: Masayuki
authors.initials: M
authors.lastname: Shinoda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001918:Brachytherapy; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome