Prognostic Analysis Of Involved-field Irradiation With Chemotherapy In Locally Advanced Esophageal Carcinoma Patients

ObjectiveThis study is to observe the failure patterns and survival in patients with locallyadvanced esophageal carcinoma （EC） receiving involved-field irradiation (IFI) withchemotherapy.Patients And MethodsThe retrospective study was preformed on the clinical records of80patients withlocally advanced EC, who have received IFI with chemotherapy between January1，2003and January1，2009in the Department of Radiation Oncology of ShandongCancer Hospital and Institute. Comparing the target volume and first sites of failure,patterns of failure were defined as in-field, out-of-field regional lymph node anddistant failure. The survival was calculated by different patterns of failure.Results1The median survival time (MST) of all the patients included was14.4months(m).2With a median follow-up of52.6m, failures were observed in76patients. In-field recurrence, distant metastases, and out-of-field regional failure wereseen in43(53.75%),33(41.24%),24(30%) patients, respectively.3There were significant difference in OS for patients with and without in-field(MST,14.2vs.17.4m, P=0.01)or distant failure(13.2vs.15.9m, P≤0.0001),but not for out-of-field regional lymph node failure(both14.5m, P=0.665).ConclusionsIn-field and distant failures, as the predominant failure patterns in advanced ECpatients, affected the prognosis of patients significantly. But the incidence of regionalfailure did not result in a worse survival. Further investigation is needed to establishthe optimal radiotherapy field for these patients at advanced stage.