Cancer Res Treat.  2017 Jul;49(3):669-677. 10.4143/crt.2016.354.

Dose-Response Relationship between Radiation Dose and Loco-regional Control in Patients with Stage II-III Esophageal Cancer Treated with Definitive Chemoradiotherapy

• Kim HJ
• Suh YG
• Lee YC
• Lee SK
• Shin SK
• Cho BC
• Lee CG

• KMID: 2388312
• DOI: http://doi.org/10.4143/crt.2016.354

Abstract

PURPOSE
The correlation between radiation dose and loco-regional control (LRC) was evaluated in patients with stage II-III esophageal cancer treated with definitive concurrent chemoradiotherapy (CRT).
MATERIALS AND METHODS
Medical records of 236 stage II-III esophageal cancer patients treated with definitive CRT at Yonsei Cancer Center between 1994 and 2013 were retrospectively reviewed. Among these, 120 received a radiation dose of < 60 Gy (standard-dose group), while 116 received ≥ 60 Gy (high-dose group). The median doses of radiation in the standard- and high-dose groups were 50.4 and 63 Gy, respectively. Concurrent 5-fluorouracil/cisplatin chemotherapy was administered to most patients.
RESULTS
There were no differences in patient characteristics between the two groups except for high Karnofsky performance status and lower-thoracic lesions being more prevalent in the standard-dose group. The median progression-free survival (PFS) and overall survival (OS) times were 13.2 months and 26.2 months, respectively. Patients in the high-dose group had significantly better 2-year LRC (69.1% vs. 50.3%, p=0.002), median PFS (16.7 months vs. 11.7 months, p=0.029), and median OS (35.1 months vs. 22.3 months, p=0.043). Additionally, LRC exhibited a dose-response relationship and the complete response rate was significantly higher in the high-dose group (p=0.006). There were no significant differences in treatment-related toxicities between the groups.
CONCLUSION
A higher radiation dose (> 60 Gy) is associated with increased LRC, PFS, and OS in patients with stage II-III esophageal cancer treated with definitive CRT.

Keyword

Esophageal neoplasms; Chemoradiotherapy; Radiation dose-response relationship

MeSH Terms

Chemoradiotherapy*
Disease-Free Survival
Dose-Response Relationship, Radiation
Drug Therapy
Esophageal Neoplasms*
Humans
Karnofsky Performance Status
Medical Records
Retrospective Studies

Figure

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  Fig. 1. Kaplan-Meier curves of locoregional control (LRC) (A), distant metastasis-free survival (DMFS) (B), progression-free survival (PFS) (C), and overall survival (OS) (D).

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  Fig. 2. Dose response relationship between radiotherapy (RT) dose and loco-regional control (LRC) durations.

Reference

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