Open Access

ARTICLE

Multi-institutional analysis of cervical esophageal carcinoma patients treated with definitive chemoradiotherapy: TROD 01-005 study

OZAN CEM GULER^1,*, EZGI OYMAK², GOZDE YAZICI³, OZLEM OZKAYA AKAGUNDUZ⁴, OGUZ CETINAYAK⁵, PETEK ERPOLAT⁶, ATIL AKSOY⁷, MURSEL DUZOVA⁸, BERNA AKKUS YILDIRIM⁹, MERAL KURT¹⁰, EMINE CANYILMAZ¹¹, GULER YAVAS¹², SERAP AKYUREK¹³, DIDEM COLPAN OKSUZ¹⁴, ESRA KAYTAN SAGLAM¹⁵, OMUR KARAKOYUN CELIK¹⁶, ENIS OZYAR¹⁷, MUSTAFA CENGIZ³, CEM ONAL^1,2,12

1 Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana Dr. Turgut Noyan Research and Treatment Center, Adana, Turkey
2 Radiation Oncology Unit, Iskenderun Gelisim Hospital, Hatay, Turkey
3 Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
4 Department of Radiation Oncology, Faculty of Medicine, Ege University, Izmir, Turkey
5 Department of Radiation Oncology, Faculty of Medicine, 9 Eylul University, Izmir, Turkey
6 Department of Radiation Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey
7 Department of Radiation Oncology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
8 Department of Radiation Oncology, Faculty of Medicine, Selcuk University, Konya, Turkey
9 Radiation Oncology Unit, Prof. Dr. Cemil Tascioglu Hospital, İstanbul, Turkey
10 Department of Radiation Oncology, Faculty of Medicine, Uludag University, Bursa, Turkey
11 Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
12 Department of Radiation Oncology, Faculty of Medicine, Baskent University, Ankara, Turkey
13 Department of Radiation Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
14 Department of Radiation Oncology, Faculty of Medicine, Istanbul University Cerrahpasa, Istanbul, Turkey
15 Radiation Oncology Unit, Memorial Sisli Hospital, Istanbul, Turkey
16 Department of Radiation Oncology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
17 Department of Radiation Oncology, Acibadem University Maslak Hospital, Istanbul, Turkey

* Corresponding Author: OZAN CEM GULER. Email:

Oncology Research 2023, 31(3), 299-306. https://doi.org/10.32604/or.2023.028840

Received 10 January 2023; Accepted 16 March 2023; Issue published 22 May 2023

Abstract

The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma (CEC) patients who underwent definitive chemoradiotherapy (CRT). The clinical data of 175 biopsy-confirmed CEC patients treated with definitive CRT between April 2005 and September 2021 were retrospectively analyzed. The prognostic factors predicting overall survival (OS), progression-free survival (PFS), and local recurrence-free survival (LRFS) were assessed in uni- and multivariable analyses. The median age of the entire cohort was 56 years (range: 26–87 years). All patients received definitive radiotherapy with a median total dose of 60 Gy, and 52% of the patients received cisplatin-based concurrent chemotherapy. The 2-year OS, PFS, and LRFS rates were 58.8%, 46.9%, and 52.4%, respectively, with a median follow-up duration of 41.6 months. Patients’ performance status, clinical nodal stage, tumor size, and treatment response were significant prognostic factors for OS, PFS, and LRFS in univariate analysis. Non-complete treatment response was an independent predictor for poor OS (HR = 4.41, 95% CI, 2.78–7.00, p < 0.001) and PFS (HR = 4.28, 95% CI, 2.79–6.58, p < 0.001), whereas poor performance score was a predictor for worse LRFS (HR = 1.83, 95% CI, 1.12–2.98, p = 0.02) in multivariable analysis. Fifty-two patients (29.7%) experienced grade II or higher toxicity. In this multicenter study, we demonstrated that definitive CRT is a safe and effective treatment for patients with CEC. Higher radiation doses were found to have no effect on treatment outcomes, but a better response to treatment and a better patient performance status did.

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