title: [Local failure-related factors of esophageal carcinoma after concurrent chemoradiotherapy].
abstract: 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.
authors.affiliation: Department of Radiotherapy Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, P. R. China.
authors.forename: Er-Cheng
authors.initials: EC
authors.lastname: Chen
authors.forename: Meng-Zhong
authors.initials: MZ
authors.lastname: Liu
authors.forename: Yong-Hong
authors.initials: YH
authors.lastname: Hu
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Qiao-Qiao
authors.initials: QQ
authors.lastname: Li
authors.forename: Ling
authors.initials: L
authors.lastname: Cai
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
authors.forename: Huan-Xin
authors.initials: HX
authors.lastname: Lin
authors.forename: Han-Yu
authors.initials: HY
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Nian-Ji
authors.initials: NJ
authors.lastname: Cui
mesh_terms: 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
chemical_list: D002945:Cisplatin; D005472:Fluorouracil