title: Survival in patients treated with definitive chemo- radiotherapy for non-metastatic esophageal cancer in north- west iran.
abstract: BACKGROUND
  Areas of Iran have among the highest incidences of esophageal cancer in the world. Definitive chemo-radiotherapy (DCRT) is used for locally advanced esophageal cancer and for inoperable tumors asan alternative to surgical treatment.
  
  
  METHODS
  This retrospective study was conducted in North- West Iran 2006-2011, including 267 consecutive patients with non-metastatic esophageal cancer. Eligible inoperable patients were treated with DCRT or definitive radiotherapy (DRT) alone. Radiotherapy (RT) was delivered at 1.8-2 Gy/day for five consecutive days in a given week. Chemotherapy (CT) consisted of cisplatin and 5-fluorouracil.
  
  
  RESULTS
  The median survival was 12.7 months with 1, 3 and 5 year survival rates of 55%, 18% and 11%, respectively. On univariate analysis, relations with age at diagnosis (p=0.015), N-stage (p=0.04), total dose of RT (p=0.001), fraction (p<0.001), Gap status (p=0.025), chemotherapeutic regimens (P=0.027), and 5-Fu Mg/m2 (P=0.004) were apparent. Comparing DCRT to DRT, there was a significant difference in survival. Multivariate analysis was performed for comparison between DCRT and DRT showed significant association with age group ≥65 to <65 (P=0.02; OR: 1.46), the total RT dose (Gy) ≥50 to <50 (P=0.01; OR: 0.65) and the fraction group ≥25 to <25 (P=<0.001; OR: 0.54).
  
  
  CONCLUSIONS
  The survival rates of esophageal cancer treated with DCRT in North West of Iran is poor; therefore, early detection and improved treatment methods, with clinical trials are a high priority.
authors.affiliation: Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. mirinezhad@gmail.com
authors.forename: Seyed Kazem
authors.initials: SK
authors.lastname: Mirinezhad
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Somi
authors.forename: Farshad
authors.initials: F
authors.lastname: Seyednezhad
authors.forename: Amir Ghasemi
authors.initials: AG
authors.lastname: Jangjoo
authors.forename: Morteza
authors.initials: M
authors.lastname: Ghojazadeh
authors.forename: Mohammad
authors.initials: M
authors.lastname: Mohammadzadeh
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Naseri
authors.forename: Behnam
authors.initials: B
authors.lastname: Nasiri
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000401:mortality*; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D002945:Cisplatin; D005472:Fluorouracil