title: [Value of postoperative radiochemotherapy for thoracic esophageal squamous cell carcinoma with lymph node metastasis].
abstract: OBJECTIVE
  To retrospectively compare the efficacy of postoperative radiotherapy (RT) alone with that of postoperative radiotherapy with concurrent chemotherapy (CRT) for thoracic esophageal squamous cell carcinoma (EPC) with positive lymph nodes, and to evaluate the clinical value of RT + CRT.
  
  
  METHODS
  304 EPC patients underwent esophagectomy with three-field lymph node dissection had pathological lymph node metastases, but no hematogenous distant metastasis. Among them, 140 cases underwent postoperative RT alone, and 164 cases underwent postoperative CRT. The dose of irradiation was 50 Gy, and the chemotherapy regimen was taxol and cis-platinum, and a cycle was 21 days.
  
  
  RESULTS
  The 1-, 3- and 5-year total survival rates of the whole group were 90.1%, 56.6% and 43.3%, respectively, with a median survival time of 49.7 months. The 5-year overall survival rates of the CRT and RT groups were 47.4% and 38.6%, respectively (P = 0.030), with a median survival time of 53.5 and 41.7 months, respectively (P = 0.030). The overall survival rates of the patients who underwent 1, 2, 3, 4 cycles of chemotherapy were 24.4%, 53.0%, 58.1% and 43.3%, respectively (P = 0.007). Among them, the 5-year total survival rate of patients with 2-4 cycles of chemotherapy was significantly better than that of patients who underwent one cycle of chemotherapy (P = 0.001). Univariate analysis showed that number of metastatic lymph nodes, pT stage, therapeutic regimen and number of chemotherapy cycles were significantly correlated with the prognosis of the patients (P < 0.05 for all). Multivariate analysis showed that number of metastatic lymph nodes, pT stage, and number of chemotherapy cycles were independent prognostic factors of the patients (P < 0.05 for all). Early toxic effects including neutropenia, radiation esophagitis, and gastrointestinal effects were significantly more severe in the CRT group than that in the RT group (P < 0.05), however, there were no significant differences of late toxic effects between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  Postoperative CRT for thoracic EPC with positive lymph nodes can improve the survival rate, with tolerable adverse effects.
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
authors.forename: Junqiang
authors.initials: J
authors.lastname: Chen
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
authors.forename: Jiancheng
authors.initials: J
authors.lastname: Li
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
authors.forename: Kunshou
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
authors.forename: Caizhu
authors.initials: C
authors.lastname: Pan
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China. Email: junqiangc@163.com.
authors.forename: Mingqiang
authors.initials: M
authors.lastname: Chen
authors.affiliation: Fujian Provincial Tumor Hospital, Fuzhou 350014, China.
authors.forename: Jianji
authors.initials: J
authors.lastname: Pan
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D059248:Chemoradiotherapy / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D004941:Esophagitis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D015182:Lymphatic Irradiation; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage; D010315:Particle Accelerators; D011184:Postoperative Period; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D017239:Paclitaxel; D002945:Cisplatin