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©The Author(s) 2018.
World J Gastroenterol. Feb 21, 2018; 24(7): 862-869
Published online Feb 21, 2018. doi: 10.3748/wjg.v24.i7.862
Published online Feb 21, 2018. doi: 10.3748/wjg.v24.i7.862
Table 1 Demographic and treatment data (n = 62)
Characteristics | n (%) | |
Sex | Female:Male | 4:58 (6.5:93.5) |
Age | Median 66 yr (range 29-86) | |
Pathology | Squamous cell carcinoma | 56 (90.3) |
Adenocarcinoma | 2 (3.2) | |
Other | 4 (6.5) | |
T stage | T1 | 14 (22.6) |
T2 | 6 (9.7) | |
T3 | 30 (48.4) | |
T4 | 12 (19.3) | |
Regional node metastasis | N0 | 14 (22.6) |
N+ | 48 (77.4) | |
Tumor length | Median 5.0 cm (range 1-14) | |
Total length of skip lesions | Median 5.0 cm (range 1-20) | |
Involved circumference | < 100% | 40 (64.5) |
100% | 22 (35.5) | |
Stenosis at diagnosis | No | 45 (72.6) |
Yes | 17 (27.4) | |
Radiation dose (EQD1.8) | Median 63 Gy (range 45-90) | |
Concurrent chemotherapy | Yes | 60 (96.8) |
No | 2 (3.2) | |
Endoscopic response | CR | 39 (62.9) |
< CR | 23 (37.1) |
Table 2 Post-radiotherapy toxicity profile
Toxicity | n (%) | RT-event interval (mo) | |
Esophagitis | RTOG Gr 1 | 19 (30.6) | |
RTOG Gr 2 | 39 (62.9) | ||
RTOG Gr 3 | 4 (6.5) | ||
RT stenosis1 | All | 16 (25.8) | Median 5.5 (range 1.1-22.5) |
Malignant | 7 (11.3) | ||
T-E fistula | All | 4 (6.5) | Median 2.6 (range 1.8-5.8) |
Malignant | 3 (4.8) |
Table 3 Factors influencing occurrence of post-radiotherapy stenosis n (%)
Characteristics | No. of Patients | Stenosis | P value | ||
No | Yes | Univariate | Multivariate | ||
Age | |||||
≤ 65 | 30 | 24 (80) | 6 (20) | 0.236 | |
> 65 | 32 | 22 (69) | 10 (31) | ||
T stage | |||||
T1/2 | 20 | 20 (100) | 0 | 0.001 | 0.998 |
T3/4 | 42 | 26 (62) | 16 (38) | ||
Involved circumference | |||||
< 100% | 40 | 37 (93) | 3 (7) | < 0.0001 | 0.003 |
100% | 22 | 9 (41) | 13 (59) | ||
Total length | |||||
< 5.0 | 28 | 22 (79) | 6 (921) | 0.338 | |
≥ 5.0 | 34 | 24 (71) | 10 (29) | ||
Stenosis at diagnosis | |||||
No | 45 | 37 (82) | 8 (18) | 0.024 | 0.995 |
Yes | 17 | 9 (53) | 8 (47) | ||
Dysphagia at diagnosis | |||||
≤ 1 mo | 36 | 30 (83) | 6 (17) | 0.051 | |
> 1 mo | 26 | 16 (62) | 10 (38) | ||
RT dose | |||||
≥ 60 Gy | 37 | 27 (73) | 10 (27) | 0.515 | |
< 60 Gy | 25 | 19 (76) | 6 (24) | ||
Endoscopic response | |||||
CR | 39 | 33 (85) | 6 (15) | 0.017 | 0.740 |
< CR | 23 | 13 (56) | 10 (44) |
Table 4 Patients with post-radiotherapy stenosis or tracheoesophageal fistula (n = 19)
Age/Sex | T stage | Involve circumf | Initial stenosis/ management | RT (Gy) | Response | Toxicity (onset, mo) | Outcome (mo) |
29/F | T3 | 100% | Dysphagia only | 59.4 | CR | Stenosis (20) | NED, alive (152) |
70/M | T3 | 100% | Total obst/none | 59.4 | PR | Stenosis (5) | DOOC (12) |
64/M | T4a | 100% | Dysphagia only | 63.0 | PR | Stenosis (1) | DM (5), DOD (7) |
68/F | T3 | 100% | Dysphagia only | 63.0 | CR | Stenosis (1) | NED, alive (21) |
75/M | T3 | 100% | Total obst/none | 63.0 | PR | Stenosis (2) | DOOC (22) |
60/F | T4b | 100% | Total obst/stent | 70.0 | CR | Stenosis (4) | NED, alive (23) |
68/M | T3 | 100% | Dysphagia only | 70.2 | SD | Stenosis (6) | InF (8), DOD (14) |
73/M | T4b | 75% | Total obst/stent | 90.01 | PR | Stenosis (11) | DM (13), DOD (17) |
64/M | T3 | 100% | Dysphagia only | 50.4 | PR | Stenosis2 (9) | InF (17), DOD (20) |
69/M | T4b | 100% | Total obst/stent | 50.4 | SD | Stenosis2 (2) | DOOC (5) |
64/M | T4a | 100% | Dysphagia only | 59.4 | PR | Stenosis2 (7) | DM (3)/InF (9), DOD (11) |
68/M | T3 | 100% | Total obst/none | 63.0 | PR | Stenosis2 (2) | DM (3), DOD (5) |
73/M | T3 | 100% | Total obst/PEG | 63.0 | PR | Stenosis2 (22) | InF (16), DOD (31) |
75/M | T3 | 40% | Dysphagia only | 57.6 | CR | Stenosis2 (14) | InF (7), DOD (31) |
74/M | T3 | 50% | Dysphagia only | 81.01 | CR | Stenosis2 (9) | InF (9), DOD (16) |
57/M | T3 | 100% | Dysphagia only | 63.0 | PR | TEF (3) | OutF (8), DOD (9) |
57/M | T3 | 100% | Total obst/stent | 60.0 | CR | Stenosis (1)/TEF2 (6) | InF (8), DOD (14) |
72/M | T3 | 100% | Total obst/stent | 63.0 | PR | TEF2 (2) | DOOC (5) |
51/M | T3 | 40% | Dysphagia only | 63.0 | PR | TEF2 (2) | RF (4), DOD (6) |
- Citation: Kim JW, Kim TH, Kim JH, Lee IJ. Predictors of post-treatment stenosis in cervical esophageal cancer undergoing high-dose radiotherapy. World J Gastroenterol 2018; 24(7): 862-869
- URL: https://www.wjgnet.com/1007-9327/full/v24/i7/862.htm
- DOI: https://dx.doi.org/10.3748/wjg.v24.i7.862