title: Prognostic factors in patients after definitive chemoradiation using involved-field radiotherapy for esophageal cancer in a phase II study.
abstract: BACKGROUND
  A prospective study was performed on the use of chemoradiotherapy (CRT) for esophageal cancer (EC) with involved-field radiation therapy (IFRT), based on 18-fluorodeoxyglucose positron-emission tomography. Prognostic factors for overall survival (OS) were analyzed.
  
  
  METHODS
  Eligible patients included 63 adults with newly diagnosed, untreated, inoperable stage I-IV EC with lymph node metastases. Patients received 80 mg/m2nedaplatin per day on day 1, 800 mg/m25-fluorouracil on days 1-4 intravenously repeated every 28 days for two to four cycles, and combined IFRT. Irradiation was applied only to the primary tumor and positive lymph nodes.
  
  
  RESULTS
  Three-year progression-free survival and OS rates were 44.9% and 47.5%, respectively. The median survival time was 31.5 months. In univariate analyses for OS, Karnofsy Performance Scale <90% (P = 0.027), initial stage (P = 0.0087), T stage (P = 0.066), N stage (P = 0.000086), M stage of M1 (P = 0.0042), dysphagia score (P = 0.00017), tumor marker squamous cell carcinoma antigen >1.5 ng/mL (P = 0.0054), gross tumor volume (GTV) > 60 cc (P = 0.00011), and relative dose intensity (RDI) of chemotherapy ≤50% (P = 0.063) were found to be associated with significantly or marginally worse OS. In multivariate analyses for OS, GTV ≥ 60 cc (P = 0.00040), RDI < 50% (P = 0.00034), and cN2-3 (P = 0.0020) were associated with significantly worse OS.
  
  
  CONCLUSIONS
  GTV, RDI and N grading, were associated with OS after definitive CRT using IFRT for EC.
authors.affiliation: Department of Radiology, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Hideomi
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Radiology, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Ryousuke
authors.initials: R
authors.lastname: Takenaka
authors.affiliation: Department of Radiology, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Kae
authors.initials: K
authors.lastname: Okuma
authors.affiliation: Department of Radiology, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Kuni
authors.initials: K
authors.lastname: Ootomo
authors.affiliation: Department of Radiology, University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009944:Organoplatinum Compounds / Q000008:administration & dosage* / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D005472:Fluorouracil
keywords: 
  Definitive chemoradiotherapy; esophageal cancer; gross tumor volume; involved-field radiotherapy; relative dose intensity