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The treatment results of definitive radiotherapy for cervical esophageal cancer: a single-institution experience

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Abstract

Background

Cervical esophageal cancer (CEC) is an uncommon disease. Thus, the clinical data from CEC patients have not been sufficient to establish a standard treatment.

Methods

Forty-six CEC patients who received definitive radiotherapy at our center from January 2003 to December 2014 were enrolled in this retrospective study. The stages of the patients according to the UICC 2002 staging system were as follows: stage I, n = 5; stage IIA + IIB, n = 3; and stage III, n = 38. The median radiation dose was 60 Gy. Thirty-nine patients (84.8%) received concurrent chemotherapy.

Results

The 3-year overall survival rate of the 46 patients was 45.4%. The 3-year laryngectomy-free survival rates of non-T4 (n = 20) and T4 patients (n = 26) were 57.8 and 23.6%, respectively; there was a significant difference (p = 0.010). Among the 35 patients who survived for >1 year after treatment, 29 (82.8%) had mild or no dysphagia and could eat solid foods. Among the 11 patients who died at more than 2 years after treatment, 6 (54.5%) died from distant metastasis. Although the number of cases is small, the results of the log-rank tests for various factors suggest that the performance status, tumor progression (TNM stage, T factor, and N factor), tumor response to definitive radiotherapy, and tumor response to induction chemotherapy might affect the prognosis.

Conclusions

Definitive radiotherapy is a promising organ-preserving treatment for CEC, especially in patients with non-T4 disease. However, new treatment strategies will be required to improve the outcomes of patients with advanced CEC, and confirmatory prospective clinical trials are required.

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Acknowledgements

Parts of this study were presented at the 70th Annual Meeting of the Japan Esophageal Society at the Prince Park Tower, Tokyo, Japan, July 4–6, 2016.

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Authors and Affiliations

  1. Department of Radiation Oncology, Saitama Cancer Center, 780 Komuro, Ina, Kita-adachi, Saitama, 362-0806, Japan

    Yu Ohkubo, Yoshihiro Saito, Shigehiro Kudo & Hiroki Ushijima

  2. Division of Gastroenterology, Saitama Cancer Center, Saitama, Japan

    Miwako Arima, Hiroki Hara & Takako Yoshii

  3. Division of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan

    Yoshiyuki Kawashima, Takashi Fukuda, Daiji Oka & Yoichi Tanaka

  4. Division of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan

    Takeshi Beppu

Authors
  1. Yu Ohkubo
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  2. Yoshihiro Saito
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  11. Yoichi Tanaka
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  12. Takeshi Beppu
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Correspondence to Yu Ohkubo.

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Ethical Statement

All procedures followed were in accordance with the approval of the Ethics Committee of the Institutional Review Board of Saitama Cancer Hospital (IRB File Number 617) and the guidelines of the Helsinki Declaration of 1975, as revised in 2000, concerning Human and Animal Rights.

Conflict of interest

The authors declare no conflicts of interest in association with the present study.

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Ohkubo, Y., Saito, Y., Kudo, S. et al. The treatment results of definitive radiotherapy for cervical esophageal cancer: a single-institution experience. Esophagus 14, 254–261 (2017). https://doi.org/10.1007/s10388-017-0574-8

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  • DOI: https://doi.org/10.1007/s10388-017-0574-8

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