مجله دانشکده پزشکی اصفهان (Aug 2014)
Influence of Chemoradiotherapy Strategies and Factors on the Five-Years Survival of Patients with Esophageal Cancer
Abstract
Background: Iran is one of the areas with higher incidence of esophageal cancer in the world. The survival benefit of surgery followed by adjuvant therapy has been demonstrated and widely accepted as a standard therapy in other gastrointestinal malignancies. Definitive chemoradiotherapy (DCRT) is used for locally advanced esophageal cancer and for inoperable tumors, thus is an alternative to surgical treatment. The purpose of the current study was to evaluate the effects of definitive and adjuvant therapy on survival of patients with esophageal cancer. Methods: This retrospective study was conducted in North-West of Iran during 2006-2011, included 331 consecutive patients with esophageal cancer referred to Radiation Oncology Therapy Center of Imam Reza (AS) Hospital in Tabriz, Iran. Health status of patients was followed by telephone contact. Survival rate and the impact of demographic characteristics, treatment modulatory and chemoradiotherapy factors in survival rate was analyzed using Kaplan-Meier Life Table and Cox regression test in SPSS software. Findings: Median survival was 14.2 months (CI 95%: 16.6-12.33). The 1, 3 and 5-year overall survival rates of all patients were 60, 21 and 16%, respectively. The factors influencing survival rate were age at diagnosis (P < 0.001), stage of disease (P < 0.001), tumor differentiation (P = 0.020), treatment modulatory (P < 0.001), radiation dose (P = 0.010), and type of drugs used in chemotherapy (P = 0.010). Among those six significant variables, independent prognostic factor for survival determined via multivariate analysis, was the radiation dose. Conclusion: The results of this study indicate that survival rates of esophageal cancer in our patients are poor. Early detection and improved treatment methods via clinical trials would help to extend the life of patients in the future.
