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. 2017 Jul;49(3):669-677.
doi: 10.4143/crt.2016.354. Epub 2016 Oct 6.

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

Hyun Ju Kim  1 , Yang-Gun Suh  2 , Yong Chan Lee  3 , Sang Kil Lee  3 , Sung Kwan Shin  3 , Byung Chul Cho  4 , Chang Geol Lee  1
Affiliations

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

Hyun Ju Kim et al. Cancer Res Treat. 2017 Jul.

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.

Keywords: Chemoradiotherapy; Esophageal neoplasms; Radiation dose-response relationship.

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Conflict of interest statement

Conflict of interest relevant to this article was not reported.

Figures

Fig. 1.
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).
Fig. 2.
Fig. 2.
Dose response relationship between radiotherapy (RT) dose and loco-regional control (LRC) durations.
See this image and copyright information in PMC

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