Prognostic Factors for Patients with Esophageal Cancer Receiving Definitive Radiotherapy Alone: A Retrospective Analysis

Abstract

Purpose

Intensity-modulated radiotherapy (IMRT) can improve the prognosis of patients with esophageal cancer. This study aimed to evaluate clinical factors relevant to the prognosis of patients with esophageal cancer who received intensity-modulated radiotherapy (IMRT) alone.

Patient and Methods

Data of 103 patients with pathologically confirmed esophageal cancer who were admitted to our hospital between October 2011 and November 2017 were retrospectively reviewed. All patients had squamous cell carcinoma. All patients received IMRT. Patients with stage I–IVA tumors were included to represent the real-world clinical practice. We performed univariate and multivariate analyses to identify prognostic factors for overall survival (OS) and progression-free survival (PFS). In univariate analyses, the Kaplan–Meier method was used to estimate OS and PFS for various subgroups. In multivariate analyses, hazard ratios were calculated.

Results

Single-factor analysis revealed that T stage (P=0.019), N stage (P =0.047), and lesion length (P =0.000) were associated with the prognosis of esophageal cancer patients who received IMRT. Cox regression analysis revealed that T stage (odds ratio [OR] = 4.68; P < 0.05), N stage (OR = 0.28; P < 0.05), and lesion length (OR = 0.09; P < 0.05) were independent factors relevant to prognosis.

Conclusion

T stage, N stage, and lesion length influenced the long-term curative effects of IMRT for esophageal cancer and were prognostic factors for patients with esophageal cancer receiving definitive radiotherapy alone. The higher the stage and the longer the tumor, the lower the survival rate.

Keywords:

• esophageal neoplasms
• prognosis
• intensity-modulated radiotherapy
• retrospective studies

Acknowledgments

I would like to show my deepest gratitude to my supervisor Dr. Min Yang and Dr. Xin-Chen Sun, respectable and responsible scholars, who have provided me with valuable guidance in every stage of writing of this thesis. Without their instructions and patience, I could not have completed my thesis. Nan Jiang and Xiao-Lin Ge are co-first authors for this study.

Abbreviations

CT, computed tomography; EC, esophageal cancer; IMRT, intensity-modulated radiation therapy; OS, overall survival; PFS, progression-free survival.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

Ethics Approval and Informed Consent

The study was approved by the ethics committee of Jiangsu Province Hospital, the exemption of informed consent has been obtained (2019-SR-410). We guarantee that all patient data will be kept confidential.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest.