title: Treatment-associated severe thrombocytopenia affects survival rate in esophageal cancer patients undergoing concurrent chemoradiotherapy.
abstract: BACKGROUND
  Esophageal cancer is commonly treated with surgery, concurrent chemoradiotherapy (CCRT), or a combination of both. The correlation between the hematological parameters during CCRT and early survival of esophageal cancer has not been fully evaluated.
  
  
  METHODS
  We analyzed the records of 65 esophageal cancer patients treated by CCRT between 2007 and 2010 retrospectively. The association between CCRT-associated myelosuppression, demographic variables, and survival rates were analyzed by univariate and multivariate analysis.
  
  
  RESULTS
  The univariate analysis showed that tumor extent of T3-4, a higher stage of tumor, a lower albumin level, grade 3 or higher anemia and thrombocytopenia, and interruptions in treatment affected survival rates. Further, the multivariate analysis revealed that stage IV (P = 0.030) is an independently negative prognostic factor for a one-year survival rate. Stage IV (P = 0.035), tumor extent of T3-4 (P = 0.002), and grade 3-4 thrombocytopenia (P = 0.015) are independently negative prognostic factors for a two-year survival rate.
  
  
  CONCLUSIONS
  Severe decrease in platelet count during CCRT independently affects survival of esophageal cancer patients in addition to stage of the tumor.
authors.forename: Y M
authors.initials: YM
authors.lastname: Huang
authors.forename: C H
authors.initials: CH
authors.lastname: Wang
authors.forename: J S
authors.initials: JS
authors.lastname: Huang
authors.forename: C S
authors.initials: CS
authors.lastname: Tsai
authors.forename: K Y
authors.initials: KY
authors.lastname: Yeh
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lan
authors.forename: T H
authors.initials: TH
authors.lastname: Wu
authors.forename: P H
authors.initials: PH
authors.lastname: Chang
authors.forename: Y S
authors.initials: YS
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Divisions of Hematology-Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: C H
authors.initials: CH
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000628:therapy