Prognostic factors after chemoradiotherapy for patients with inoperable esophageal squamous cell carcinoma.
OBJECTIVE
It is important to clarify the predictive and prognostic factors for chemoradiotherapy (CRT) in patients with inoperable esophageal cancer.


METHODS
Forty-one patients with inoperable advanced esophageal cancer were evaluated. The predictive factors for the response to CRT (low-dose 5-FU and Cisplatin (FP) therapy plus 60 Gy of radiation) and the prognostic factors after CRT were analyzed.


RESULTS
Of the 41 patients, seven achieved complete remission, 21 achieved partial remission, nine showed no change and four showed progressive disease. The median survival time was 19 months in patients with a tumor response, compared to 7 months in patients with non-responsive tumors. Only the serum cytokeratin (CYFRA) level independently predicted the responsiveness to treatment. In the multivariate analysis, the serum CYFRA level and the p53 gene mutation independently influenced prognosis.


CONCLUSIONS
The presence of a p53 mutation in the biopsy specimen or a high serum CYFRA level may be predictive of an adverse therapeutic outcome.
Kunisaki
Chikara
C
Department of Surgery, Gastroenterological Center, Yokohama City University, Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. s0714@med.yokohama-cu.ac.jp
Imada
Toshio
T
Yamada
Roppei
R
Hatori
Shinsuke
S
Kinbara
Kazuhiro
K
Watai
Kiichi
K
Akiyama
Hirotoshi
H
Nomura
Masato
M
Matsuda
Goro
G
Otsuka
Yuichi
Y
Ono
Hidetaka
H
Shimada
Hiroshi
H
D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D053539:Keratin-19; D007633:Keratins / Q000097:blood; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011379:Prognosis; D016019:Survival Analysis; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D053539:Keratin-19; D016159:Tumor Suppressor Protein p53; C102012:antigen CYFRA21.1; D007633:Keratins; D002945:Cisplatin; D005472:Fluorouracil