Retrospective analysis of definitive radiotherapy for patients with superficial esophageal carcinoma: Consideration of the optimal treatment method with a focus on late morbidity

Abstract 

Purpose

To evaluate the clinical efficacy of definitive radiotherapy for patients with superficial esophageal cancer.

Material and methods

From 1990 through 2006, 97 patients with stage I disease were treated with radiotherapy with or without chemotherapy. All patients were diagnosed with panesophagoscopy and computed tomography. Chemotherapy was added in 61 patients, and intra-cavitary brachytherapy (ICBT) was used in 27 patients.

Results

The patients were 90 men and seven women with a median age of 65.7years (range; 41–89). At last follow-up with a median follow-up duration of 35.7months, 3year-overall and progression-free survival (PFS) rates were 81.5% (95% C.I.=73.3–89.7%) and 55.8% (95% C.I.=45.2–66.4%), respectively. Shorter tumor length was a significantly favorable factor for the PFS rate (P=0.02) and local failure-free (LFF) rate (P=0.007) on both univariate and multivariate analyses. Although the addition of ICBT had no apparent benefit for survival or tumor control, the rate of severe adverse effects including lethal esophageal ulcers, showed a higher tendency in patients receiving ICBT.

Conclusions

Our results regarding efficacy from the viewpoint of organ preservation are promising. Special care would be taken for the use of ICBT for patients with superficial esophageal cancer, especially if they have received chemoradiotherapy.

Keywords: Superficial esophageal cancer, Second primary, Definitive radiotherapy, Iodine staining