Efficacy and Prognosis of Chemoradiotherapy for 501 Patients With Postoperative Recurrence of Esophageal Cancer

Abstract

Background: To analyze the efficacy and prognosis of chemoradiotherapy for patients with recurrence of esophageal cancer. Method: A single center study was conducted in 501 patients with recurrent esophageal cancer who received chemotherapy and radiotherapy. Univariate or multivariate analysis was performed to assess the survival, recurrence pattern, prognosis of retreatment and influencing factors. Result: The median time to recurrence of esophageal cancer was 11.6 months (range: 0.3-87.4 months), while the median survival time of chemoradiotherapy after recurrence was 12.1 months. Multivariate analysis identified gender, pN stage, log odds of positive lymph nodes (lodds) value, chemotherapy cycle, recurrence time, and combined distant metastasis as independent prognostic factors (P=0.002, 0.035, 0.000, 0.000, 0.000, 0.001). In this study, 157 patients had combined combined distant metastasis, and the 1-, 3-, and 5-year survival rates of these patients after radiotherapy were 43.3%, 9.1%, and 5.5%, respectively. On the contrary, the 1-, 3-, and 5-year survival rates of patients with local regional recurrence (LRR) only were 53.6, 22.6%, and 16.4%, respectively. Statistically, the differences in the survival rates were significant between the above two groups of patients (B=10.786, P=0.001). Meanwhile, we identified recurrence time, chemotherapy cycle, and prescribed dose as the significant factors affecting the prognosis among 344 patients with postoperative LRR only (a=22.605, 13.957, 10.446; P=0.000, 0.000, 0.005). Conclusion: This study showed that chemoradiotherapy is safe and effective in patients with recurrent esophageal cancer, while male patients with late pN stage, high lodds, chemotherapy of ≤ 2 cycles, recurrence time of ≤ 24 months, or combined distant metastasis had a poor prognosis.

Status of diagnosis and treatment of esophageal cancer and non-coding RNA correlation research: a narrative review

“…Nowadays for early and terminal stage esophageal cancer with distant metastasis, surgery is still the first choice; for stage I and II esophageal cancer, surgical resection is the only possible way to remove the tumor ( 22 , 23 ), but it may have side effects ( 23 , 24 ), such as intraoperative trauma, complication (pulmonary complications and anastomotic fistula, etc. ( 24 ), survival problem (such as difficulty in feeding and nutrition, and the long-term survival rate is low) as well as tumor recurrence and metastasis ( 25 ). Theoretically, chemo-radiotherapy and other adjuvant therapies can eliminate residual lesion tissues and lesion tissues caused by tumor cell metastasis in vivo, thus reducing local recurrence and improving overall survival rate (OS), but there are still problems in radiotherapy sensitivity and resistance to chemotherapy drugs ( 26 ).…”