Influence of chemoradio therapeutic strategies and factors on the five yearssurvival of patients with esophageal cancer

Abstract

Background: Iran is one of the areas with higher incidence of esophageal cancer in the world.The survival benefit of surgery followed by adjuvant therapy has been demonstrated and widely accepted as a standard therapy in other gastrointestinal malignancies. Definitive chemo radiotherapy (DCRT) is used for locally advanced esophageal cancer and for inoperable tumors thus is an alternative to surgical treatment. The purpose of the current study is to evaluate the effects of Definitivetherapy and adjuvant therapy on survival of Patients with esophageal cancer. Methods: This retrospective study was conducted in North-West of Iran 2006 - 2011, included of 331 consecutive patients with esophageal cancer that referred toRadiation Oncology Therapy of Imam Reza (AS) Hospital in Tabriz. Health status of patients followed by Telephone contact.Survival rate and the impact of demographic characteristics, treatmentmodulatory and chemoradiotheraptic factors in survival rate was analyzed with Kaplan- Meier, Life Table and Cox regression in SPSS software (16). Findings: Median survival was 14.2 (CI95% : 16.6 - 12.33) months. The 1-, , 3-, and 5-year overall survival rates of all patients were 60 , 21 and 16 %, respectively. The factors influencing survival rate were, age at diagnosis (p <0.001), stage of disease (p <0.001), Tumor differentiation (0.02 = P), treatment modulatory (p <0.001), radiation dose (p = 0. 01) and type of drugs used in chemotherapy (P = 0.01). Among those six significant variables verified by univariate analysis, independent prognostic factor for survival determined by multivariate analysis was the radiation dose. Conclusion: The results of this study indicate that survival rates of esophageal cancer in our patients are poor.Early detection and improved treatment methods with clinical trial will help to extend the life of patients in the future. é 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved.