[Local failure-related factors of esophageal carcinoma after concurrent chemoradiotherapy].
OBJECTIVE
Concurrent chemoradiotherapy is the standard treatment for unresectable esophageal carcinoma. Local failure and recurrence are main reasons of treatment failure. This study was to discuss the factors related with local failure and recurrence of unresectable esophageal carcinoma after concurrent chemoradiotherapy.


METHODS
Records of 132 patients with esophageal carcinoma, treated with concurrent chemotherapy in our hospital from Jan. 1996 to Dec. 2003, were reviewed. The patients received the first cycle of chemotherapy at the beginning of radiotherapy, and the second cycle of chemotherapy when radiation dose escalated to 40 Gy. Local failure-related factors were analyzed by binary logistic regression.


RESULTS
To the terminal of follow-up, of the 132 patients, 54 had local failure or in-fields recurrence, 20 had in-fields recurrence and lymph nodes or distant metastasis, 5 had out-fields recurrence. Logistic regression analysis showed that short-term effect and irradiation dose were correlated with local failure and recurrence. Local failure and recurrence rate was lower in patients with complete remission (CR) than in patients with partial remission (PR) after chemoradiotherapy (44.9% vs. 79.6%, P < 0.001); and the mean time to recurrence was longer in CR patients than in PR patients (12.9 months vs. 6.1 months, P=0.002). When irradiated with 50-60 Gy,60.1-69.9 Gy, >/=70 Gy of x-ray, the local failure rates of the patients were 69%, 61%, and 52% (P=0.027), respectively, the mean time to recurrence were 5.3, 9.1, and 10.3 months, respectively.


CONCLUSIONS
Radiation dose and short-term effect may influence local control of unresectable esophageal carcinoma.
Chen
Er-Cheng
EC
Department of Radiotherapy Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, P. R. China.
Liu
Meng-Zhong
MZ
Hu
Yong-Hong
YH
Liu
Hui
H
Li
Qiao-Qiao
QQ
Cai
Ling
L
Huang
Ying
Y
Lin
Huan-Xin
HX
Wang
Han-Yu
HY
Liu
Hui
H
Cui
Nian-Ji
NJ
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011829:Radiation Dosage; D012074:Remission Induction; D017211:Treatment Failure
D002945:Cisplatin; D005472:Fluorouracil