title: Analysis of failure patterns in patients with resectable esophageal squamous cell carcinoma receiving chemoradiotherapy.
abstract: OBJECTIVE
  This study investigates the failure pattern after chemoradiotherapy of patients with resectable esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  We retrospectively analyzed 92 patients with T1-2, N0-1, and M0 ESCC. These patients were inoperable because of poor performance, comorbidities, poor tumor region, or refusal of operation.
  
  
  RESULTS
  Among the 92 patients, 29 cases displayed simple locoregional recurrence, 12 cases displayed simple distant metastasis, and 6 cases displayed distant metastasis with locoregional recurrence. Univariate analysis shows that the incidence of recurrence in the middle thoracic region was significantly higher than other regions (χ2 = 14.415, P = 0.001). For the 18 patients with distant metastasis, incidence of distant metastasis in the lower thoracic region was significantly higher than the other regions (= 39.359, P < 0.001). Among 35 cases with regional recurrence, 7 cases reached complete remission (14.6%) and 28 cases reached partial remission (PR; 63.6%) (χ2= 23.435, P < 0.001). Multivariate analysis shows that the patient age, tumor node metastasis (TNM) stage, and short-term efficacy were independent factors for locoregional recurrence. Patient age, TNM stage, X-ray length of the lesions, and short-term efficacy were the independent factors for distant metastases.
  
  
  CONCLUSIONS
  The incidence of locoregional recurrence and distant metastasis in patients with upper thoracic esophageal cancer was lower than those who had middle thoracic and lower thoracic esophageal cancer. The incidence of locoregional recurrence and distant metastasis in patients who achieved complete response after treatment was low.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Shen
authors.affiliation: Department of Radiation Oncology, The Forth Hospital of Hebei Medical University, Shijiazhaung, China.
authors.forename: Shu-Chai
authors.initials: SC
authors.lastname: Zhu
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Gao
authors.forename: You-Mei
authors.initials: YM
authors.lastname: Li
authors.forename: Jin-Wei
authors.initials: JW
authors.lastname: Su
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.forename: Zhi-Kun
authors.initials: ZK
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D059248:Chemoradiotherapy / Q000009:adverse effects*; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging