e15121 Background: Definitive chemoradiotherapy (dCRT) has been used as a standard care for treating and palliating of symptoms in advanced esophageal cancer patients even if they have metastatic disease. The purpose of this study is to identify the treatment outcomes and prognostic factors for survival in squamous cell type of esophagus. Methods: We retrospectively studied the patients who treated with dCRT using 5-FU and cisplatin, and histologically proven squamous cell esophageal carcinoma of stage III and IV between January 2004 and December 2010. Results: In total 110 patients were enrolled in analysis of whom 64 patients were stage III and Iva (localized advanced) and 46 patients were stage IVb. The ratio of male/female was 109/1 and the median age was 65 years. T-stage was cT2=8%, cT3=75, cT4=17% and N-stage was cN0=5%, cN1=95%. The most common metastatic site was distant LN (60%). The median dose of radiation was 5400 cGy (range, 4400-6600). The median OS for locally advanced and metastatic disease group was 19.0 and 12.8 months, respectively (p=0.032). The median PFS for these groups was 8.3 and 6.9 months, respectively (p=0.208). The most common pattern of failure was locoregional area. In univariate analysis, cell type (poorly differentiation), dysphagia score, PS (ECOG 1-2 vs. 0), PFS (<5months) and CRP were significantly associated with OS and cell type, PS, PFS were shown significantly poor prognostic factors for OS in multivariate analysis. Among the patients who had locally advanced disease, maintenance chemotherapy after dCRT did not influence the OS. However, “good risk” patients who had less than 2 risk factors receiving maintenance chemotherapy showed better OS than those with no maintenance chemotherapy (40.9 vs. 12.3 months; p=0.011). Conclusions: dCRT has a major role in improving survival and palliation of dysphagia in inoperable advanced esophageal cancer even in metastatic stage. Cell type and PS have been still important prognostic factors in survival. In addition, maintenance chemotherapy after dCRT may be helpful for prolongation survival in good risk patients.
Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy
