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• W4229763259 abstract "To analyze the evolution of treatment and outcome for esophageal cancer at a single institution, we performed retrospective analysis for patients with esophageal cancer who received radiotherapy as the sole modality or as a component of multimodality treatment at our institution. Six hundred thirty-five consecutive patients with primary esophageal cancer received radiotherapy as a sole treatment modality or as a component of multimodality therapy from 1/1985, when CT scan became available for routine pretreatment evaluation, to 12/2002. Change in patient demographics was analyzed in this population. Patients who did not have metastatic disease were included in a multivariate analysis to identify factors associated with long-term survival. Patients were divided into 4 cohorts at 5-year interval starting from 1985 for comparison. From 1985 to 2002, there was a progressive white (79% to 87%) male (65% to 83%) predominance, increased incidence of adenocarcinoma (37.5% to 68%) located in the lower esophagus and the gastraesophageal junction (36% to 66%) in the population studied. The median age remained stable at 62–63 years. At diagnosis, the proportion of patients currently smoking decreased from 44% to 20%, whereas the proportion of patients who quit smoking increased from 35% to 74%. The median radiation dose was 45 to 50 Gy in all cohorts except the cohort from 1990–1994, when median radiation dose was 30 Gy in 10 fractions. The proportion of patients who received chemotherapy increased from 64% to 94%, while the proportion of patients who underwent surgery remained stable at about 50% at all time intervals. For all comers during the study period, the rates of 5-year overall survival (OS), disease free survival (DFS), distant metastasis free survival (DMFS), and locoregional control (LRC) were 20.2%, 22.3%, 63.6% and 43.2%, respectively. Table 1 shows the patients demographics and 3 -yr survival. Multiple drug chemotherapy, concurrent chemoradiation, surgery, 3-Dimensional radiation technique with 18 Mv photons, total radiation dose were significant predictive therapeutic factors for overall survival in multivariate analysis. There has been a change in patient demographics with an increased incidence of adenocarcinoma at the lower esophagus/GEJ. However, there was not a significant change in median radiation dose or the proportion of patients undergoing surgery. The most striking change in therapeutic modality for this disease was increased utilization of concurrent chemoradiation, intensity of chemotherapy, and improved radiation technique. Overall survival of patients with esophageal cancer who received radiation therapy has increased over time." @default.
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• W4229763259 date "2004-09-01" @default.
• W4229763259 modified "2023-10-17" @default.
• W4229763259 title "Treatment outcome of irradiated esophageal cancer" @default.
• W4229763259 doi "https://doi.org/10.1016/s0360-3016(04)01369-0" @default.
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