Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma
Abstract Background The aim of this study was to identify the long-term clinical outcome of definitive radiotherapy using three-dimensional conformal radiotherapy (3DCRT) for cervical esophageal squamous cell carcinoma (CESCC). Methods We retrospectively reviewed the medical records of 30 patients w...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13014-018-0957-6 |
| _version_ | 1811281187716464640 |
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| author | Katsuyuki Sakanaka Yuichi Ishida Kota Fujii Satoshi Itasaka Shin’ichi Miyamoto Takahiro Horimatsu Manabu Muto Takashi Mizowaki |
| author_facet | Katsuyuki Sakanaka Yuichi Ishida Kota Fujii Satoshi Itasaka Shin’ichi Miyamoto Takahiro Horimatsu Manabu Muto Takashi Mizowaki |
| author_sort | Katsuyuki Sakanaka |
| collection | DOAJ |
| description | Abstract Background The aim of this study was to identify the long-term clinical outcome of definitive radiotherapy using three-dimensional conformal radiotherapy (3DCRT) for cervical esophageal squamous cell carcinoma (CESCC). Methods We retrospectively reviewed the medical records of 30 patients with CESCC [clinical stage I/II/III/IV(M1LYM); 3/2/12/13] (TNM 7th edition) who underwent definitive radiotherapy using 3DCRT between 2000 and 2014 in our institution. The median prescribed dose for the gross tumor and metastatic lymph nodes was 60 Gy. Twenty-six patients underwent elective nodal irradiation for the neck node levels III, IV, and VI and for upper mediastinal lymph nodes with a median dose of 40 Gy. Twenty-six patients underwent concurrent chemotherapy. Initial disease progression sites, locoregional control (LRC) rate, overall survival (OS) rate, and toxicities were retrospectively evaluated. A univariate analysis was performed to identify prognostic factors. Results With a median follow-up of 110 months, the 5- and 10-year LRC rates were 43.7% and 37.4%, respectively. The 5- and 10-year OS rates were 48.3% and 40.2%, respectively. Locoregional, distant and both area accounted for 83%, 6% and 11% of the initial progression sites. Unresectable status and M1LYM were significantly associated with poor LRC (p < 0.05) and OS (p < 0.05). Grade 3 acute non-hematological toxicity occurred in 13.3% of patients. During the follow-up, patients without any disease progression did not need a permanent gastrostomy tube or tracheostomy. Late toxicity events, including hypothyroidism and cardiovascular disease, were observed; 5- and 10-year cumulative incidence rates of grade 2 hypothyroidism and ≥grade 3 cardiovascular disease were 31.6% and 62.5%, and 17.5% and 21.3%, respectively. Conclusions Definitive radiotherapy yields a cure for patients with CESCC while preserving their laryngopharyngeal function. The poor LRC rate in the advanced stage needs to be overcome for a better prognosis. As the incidence of radiation-induced hypothyroidism and cardiovascular disease was not low, long-term survivors should be followed up for these symptoms. |
| first_indexed | 2024-04-13T01:28:57Z |
| format | Article |
| id | doaj.art-cef65f0cb5464da48cd8e806dc97aa65 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-04-13T01:28:57Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-cef65f0cb5464da48cd8e806dc97aa652022-12-22T03:08:34ZengBMCRadiation Oncology1748-717X2018-01-011311810.1186/s13014-018-0957-6Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinomaKatsuyuki Sakanaka0Yuichi Ishida1Kota Fujii2Satoshi Itasaka3Shin’ichi Miyamoto4Takahiro Horimatsu5Manabu Muto6Takashi Mizowaki7Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto UniversityDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto UniversityDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto UniversityDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto UniversityDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto UniversityDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityDepartment of Therapeutic Oncology, Graduate School of Medicine, Kyoto UniversityDepartment of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto UniversityAbstract Background The aim of this study was to identify the long-term clinical outcome of definitive radiotherapy using three-dimensional conformal radiotherapy (3DCRT) for cervical esophageal squamous cell carcinoma (CESCC). Methods We retrospectively reviewed the medical records of 30 patients with CESCC [clinical stage I/II/III/IV(M1LYM); 3/2/12/13] (TNM 7th edition) who underwent definitive radiotherapy using 3DCRT between 2000 and 2014 in our institution. The median prescribed dose for the gross tumor and metastatic lymph nodes was 60 Gy. Twenty-six patients underwent elective nodal irradiation for the neck node levels III, IV, and VI and for upper mediastinal lymph nodes with a median dose of 40 Gy. Twenty-six patients underwent concurrent chemotherapy. Initial disease progression sites, locoregional control (LRC) rate, overall survival (OS) rate, and toxicities were retrospectively evaluated. A univariate analysis was performed to identify prognostic factors. Results With a median follow-up of 110 months, the 5- and 10-year LRC rates were 43.7% and 37.4%, respectively. The 5- and 10-year OS rates were 48.3% and 40.2%, respectively. Locoregional, distant and both area accounted for 83%, 6% and 11% of the initial progression sites. Unresectable status and M1LYM were significantly associated with poor LRC (p < 0.05) and OS (p < 0.05). Grade 3 acute non-hematological toxicity occurred in 13.3% of patients. During the follow-up, patients without any disease progression did not need a permanent gastrostomy tube or tracheostomy. Late toxicity events, including hypothyroidism and cardiovascular disease, were observed; 5- and 10-year cumulative incidence rates of grade 2 hypothyroidism and ≥grade 3 cardiovascular disease were 31.6% and 62.5%, and 17.5% and 21.3%, respectively. Conclusions Definitive radiotherapy yields a cure for patients with CESCC while preserving their laryngopharyngeal function. The poor LRC rate in the advanced stage needs to be overcome for a better prognosis. As the incidence of radiation-induced hypothyroidism and cardiovascular disease was not low, long-term survivors should be followed up for these symptoms.http://link.springer.com/article/10.1186/s13014-018-0957-6Esophageal NeoplasmsRadiotherapyConformalLong-term outcomeHypothyroidismCardiovascular disease |
| spellingShingle | Katsuyuki Sakanaka Yuichi Ishida Kota Fujii Satoshi Itasaka Shin’ichi Miyamoto Takahiro Horimatsu Manabu Muto Takashi Mizowaki Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma Radiation Oncology Esophageal Neoplasms Radiotherapy Conformal Long-term outcome Hypothyroidism Cardiovascular disease |
| title | Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma |
| title_full | Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma |
| title_fullStr | Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma |
| title_full_unstemmed | Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma |
| title_short | Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma |
| title_sort | long term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma |
| topic | Esophageal Neoplasms Radiotherapy Conformal Long-term outcome Hypothyroidism Cardiovascular disease |
| url | http://link.springer.com/article/10.1186/s13014-018-0957-6 |
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