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Session Item

Sunday
November 29
08:00 - 08:40
Physics Stream 2
Dose calculation in external beam radiotherapy: The radiation transport equation and dose-to-water vs. dose-to-medium issues
2068
Teaching Lecture
Physics
14:15 - 14:23
Pattern of care and outcomes in stage III esophageal cancer receiving definitive chemoradiation
PH-0156

Abstract

Pattern of care and outcomes in stage III esophageal cancer receiving definitive chemoradiation
Authors: CHOU|, Ying-Hsiang(1)*[hideka.chou@gmail.com];Lee|, Yueh-Chun(1);Chiou|, Jeng-Yuan (2);Chen|, Hsin-Lin (1);Tseng|, Hsien-Chun(1);Huang|, Chien-Ning(3);Huang|, Jing-Yang (4);
(1)Chung Shan Medical University Hospital, Radiation Oncology, Taichung, Taiwan;(2)Chung Shan Medical University, School of Health Policy and Management, Taichung, Taiwan;(3)Chung Shan Medical University Hospital, Institute of Medicine, Taichung, Taiwan;(4)Chung Shan Medical University Hospital, Department of Medical Research, Taichung, Taiwan;
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Purpose or Objective

Multimodality approach is recommended to treat stage III esophageal cancer (EsoC).  However, the most optimal radiation dose to be delivered for patients receiving definitive chemoradiotherapy (dCCRT) is still in debate. Here we report the pattern of care and survival outcomes for stage III EsoC patients receiving dCCRT in Taiwan.

Material and Methods

Patients who were diagnosed as having stage III EsoC and received dCCRT between 2010 and 2015 were retracted from the Taiwan Cancer Registry database for analysis. The overall survival (OS) rates were calculated by the Kaplan-Meier method. The prognostic factors were identified by using the Cox regression hazards model. 

Results

A total of 2047 patients were included in the study and the median radiation dose delivered is 5940cGy. Out of the entire cohort, 991 patients were allocated into the low-dose group (RT dose 4000-5939cGy) while 1056 patients were allocated into the high-dose group (RT dose ≥5940cGy). One-and 5-year OS were significantly better among patients in the high-dose group. Survival rates at 1 year were 52 % and 44% in the 2 groups, respectively. Survival rates at 5 years were 16% and 11% (p<0.0001) in the two groups, respectively. The prognostic factors for OS include radiation dose delivered, sex, cancer site, clinical T/N status, and body mass index. In subgroup analysis, those in the high-dose group showed a significant survival benefit in patients with cT3N1 (p= 0.0076), cT4N2 (p = 0.02) and cT4N3 (p = 0.0215) stage. 
Fig. Overall Survival between 2 groups

Conclusion

In Taiwan, more than half of the stage III EsoC patients who were treated with dCCRT received a radiation dose greater than 5940cGy. The results of this study indicate that those received a higher radiation dose greater than 5940cGy had a better OS than those received a radiation dose lower than 5940cGy.