Results and prognostic factors of 3-dimensional conformal radiotherapy and intensity-modulated radiotherapy for esophageal carcinoma

The aim of this study was to summarize the outcomes and prognostic factors of 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for esophageal carcinoma in our institute. Five hundred ninety-two patients received radiotherapy for esophageal carcinoma (123 with 3D-CRT, 469 with IMRT) from January 2002 to March 2012. Three hundred sixty patients received radiotherapy alone and 232 patients received radiotherapy and chemotherapy. The endpoints were overall survival (OS), progression-free survival (PFS). Kaplan-Meier analysis was used to calculate endpoints, the log-rank test for univariate analysis, and multivariate analysis to identify independent prognostic factors. The median follow-up time was 22.6 months and the median dose was 60 Gy. The 1-year OS, PFS were 65.3%, 52.1%; the 3-year OS, PFS were 34.0%, 28.0%; and the 5-year OS, PFS were 23.5%, 19.6%. The median OS was 20 months (95% CI: 17.9-22.1 months) and the median PFS was 14 months (95% CI: 11.8-16.2 months). Univariate analysis indicated that sex, N-stage, M-stage, TNM stage, radiotherapy dose, weight loss before treatment, smoking, and drinking affected OS and PFS (p < 0.05 for all). T-stage affected OS (p = 0.042), but no significant influence on PFS (p = 0.101). The independent prognostic factors for better OS and PFS were early clinical TNM stage, high radiotherapy dose, and female sex (p < 0.05 for all). The results of esophageal carcinoma patients treated with 3D-CRT and IMRT with or without chemotherapy were promising. Clinical TNM stage, radiotherapy dose and sex were the independent prognostic factors for OS and PFS.