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Mapping of Regional Failures After Definitive Radiotherapy in Patients with Locally Advanced Cervical Esophageal Carcinoma

Authors Zhao D, Zheng B, Xiao S, Liu W, Xu X, Yu H, Sun Y, Wang W

Received 2 April 2020

Accepted for publication 15 June 2020

Published 2 July 2020 Volume 2020:12 Pages 5293—5299

DOI https://doi.org/10.2147/CMAR.S256680

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Sanjeev Srivastava


Dan Zhao, Baomin Zheng, Shaowen Xiao, Weixin Liu, Xiaolong Xu, Huiming Yu, Yan Sun, Weihu Wang

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital Institute, Beijing, People’s Republic of China

Correspondence: Weihu Wang; Yan Sun
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Beijing Cancer Hospital & Institute, 52# Fucheng Road, Haidian District, Beijing 100142, People’s Republic of China
Tel/ Fax +86-10-88196120
; +86-10-88196217 Email wangweihu88@163.com; lisaysun@139.com

Purpose: This study aimed to retrospectively analyze the failure patterns and clinical outcomes in patients with locally advanced cervical esophageal carcinoma (CEC) after definitive radiotherapy (RT), and illustrate the mapping of regional failures.
Patients and Methods: We reviewed 82 patients with CEC confirmed as squamous cell carcinoma who had completed definitive RT from August 2008 to December 2017. Data on clinical characteristics were collected from the medical records system. Patterns of treatment failures and the survival follow-up were analyzed.
Results: The median age was 58 (38– 78) years. In 37 patients, the lesions were limited to the cervical esophagus, while in the remaining 45 patients, the disease got beyond the cervical esophagus (pharynx or thoracic esophagus involved). While 10 patients had stage Ⅱ disease, 72 had stage III disease. The completed median dose for 95% PGTV and 95% PTV was 66 Gy and 58 Gy. While the median follow-up was 27.6 months, the median progression-free survival (PFS) and overall survival (OS) was 16.1 and 28.3 months, respectively. The 3-year PFS and OS was 30.3% and 45.3%, respectively. Treatment failures were reported in 55 patients, of which 22, 8, 7, 9, 2, 3, and 4 patients had developed local, regional, distant, local-regional, regional-distant, local-distant and local-regional-distant failure, respectively. Of the 41 relapsed nodal sites, 28 were located “in-field” whereas 1 was “marginal” and 12 were “out-field”. The most frequent regional relapses were at level VIb, IV and the upper-middle mediastinum.
Conclusion: Regional recurrences focused on lower neck and upper-middle mediastinum, and mainly “in-field”, after definitive RT in patients with CEC.

Keywords: esophageal neoplasms, prognosis, radiotherapy, recurrence, squamous cell carcinoma

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