Long Outcome of Radiotherapy for Esophageal Carcinoma and Efficacy Comparison of Different Treatment Methods

Objective To analyze the long outcome of radiotherapy for esophageal carcinoma and,compare the efficacy of different treatment methods. Methods We retrospectively analyzed 170 esophageal carcinoma patients who received radical radiotherapy from Oct. 2000 to Mar. 2003 Radiotherapy efficacy, prognostic factors, failure mode, side effect and quality of life(QOL) were analyzed. Results The 3-, 5- and 10-year survival rates were 30.59%, 24.12% and 11.76% respectively. There were no statistically significant differences in survival rates among 3-dimensional conformal radiotherapy(3D-CRT) group, late course accelerated hyperfraction(LCAF) group and conventional fraction radiotherapy(CF) group (χ²=2.41, P=0.2990). Multivariate analysis showed that with or without chest pain before treatment, clinical stage, presence of soft tissue shadow and ≥grade 2 radiation esophagitis (RE) were independent prognosis factors. There were no statistically significant differences in recurrence or metastasis rates among different groups (χ²=4.619, P=0.099, χ²=3.221, P=0.200). There were no statistically differences in ≥grade 2 RE or ≥grade 2 radiation pneumonia (RP) between different groups (χ²=0.442, 4.281;P=0.802,0.118); while there were significant differences in incidence rates of ≥grade 2 RP between 3D-CRT and LCAF group (χ²=4.306, P=0.038). QOL was good in living patients. Conclusion The long-term outcome of esophageal carcinoma patients who received radiotherapy is good. Regional recurrence and distant metastasis are still the main failure modes. Compared with LCAF, 3D-CRT could significantly reduce the incidence rate of ≥grade 2 RP.