Long-term results of chemoradiotherapy for stage II-III thoracic esophageal cancer in a single institution after 2000 -with a focus on comparison of three protocols.
BACKGROUND
To evaluate the long-term results of chemoradiotherapy (CRT) for stage II-III thoracic esophageal cancer mainly by comparing results of three protocols retrospectively.


METHODS
Between 2000 and 2012, 298 patients with stage II-III thoracic esophageal cancer underwent CRT. Patients in Group A received two cycles of cisplatin (CDDP) at 70 mg/m(2) (day 1 and 29) and 5-fluorouracil (5-FU) at 700 mg/m(2)/24 h (day 1-4 and 29-32) with radiotherapy (RT) of 60 Gy without a break. Patients in Group B received two cycles of CDDP at 40 mg/m(2) (day 1, 8, 36 and 43) and 5-FU at 400 mg/m(2)/24 h (day 1-5, 8-12, 36-40 and 43-47) with RT of 60 Gy with a 2-week break. Patients in Group C received two cycles of nedaplatin at 70 mg/m(2) (day 1 and 29) and 5-FU at 500 mg/m(2)/24 h (day 1-4 and 29-32) with RT of 60-70 Gy without a break. Differences in prognostic factors between the groups were analyzed by univariate and multivariate analyses.


RESULTS
The 5-year overall survival rates for patients in Group A, Group B and Group C were 52.4, 45.2 and 37.2%, respectively. The 5-year overall survival rates for patients in Stage II, Stage III (non-T4) and Stage III (T4) were 64.0, 40.1 and 22.5%, respectively. The 5-year overall survival rates for patients who received 1 cycle and 2 cycles of concomitant chemotherapy were 27.9 and 46.0%, respectively. In univariate analysis, stage, performance status and number of concomitant chemotherapy cycles were significant prognostic factors (p < 0.001, p = 0.008 and p < 0.001, respectively). In multivariate analysis, stage, protocol and number of concomitant chemotherapy cycles were significant factors (p < 0.001, p = 0.043 and p < 0.001, respectively).


CONCLUSIONS
The protocol used in Group A may be an effective protocol of CRT for esophageal cancer. It may be important to complete the scheduled concomitant chemotherapy with the appropriate intensity of CRT.
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. reirei513@hotmail.com.
Rei
R
Umezawa
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. kjingurad@yahoo.co.jp.
Keiichi
K
Jingu
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. harumatsu2001@yahoo.co.jp.
Haruo
H
Matsushita
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. sugatosi772288@yahoo.co.jp.
Toshiyuki
T
Sugawara
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. satoharuapple@yahoo.co.jp.
Masaki
M
Kubozono
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. priere_for@yahoo.co.jp.
Takaya
T
Yamamoto
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. y02614111@yahoo.co.jp.
Yojiro
Y
Ishikawa
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. drmk2009@yahoo.co.jp.
Maiko
M
Kozumi
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. noriyoshi.08.25@gmail.com.
Noriyoshi
N
Takahashi
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. ykhasedo@yahoo.co.jp.
Yu
Y
Katagiri
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. kadoya.n@rad.med.tohoku.ac.jp.
Noriyuki
N
Kadoya
Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, Sendai, Japan. takedak41@yahoo.co.jp.
Ken
K
Takeda
Department of Radiology, Iwate Medical University School of Medicine, Morioka, Japan. hariga2525@gmail.com.
Hisanori
H
Ariga
Department of Radiation Oncology, Yamagata University School of Medicine, Yamagata, Japan. knemoto@ymail.plala.or.jp.
Kenji
K
Nemoto
Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1, Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. shogo-y@rad.med.tohoku.ac.jp.
Shogo
S
Yamada
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D059248:Chemoradiotherapy / Q000379:methods / Q000639:trends*; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000639:trends; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors