Survival and failure outcomes of neoadjuvant/definitive radiotherapy in locally advanced esophageal and gastro-oesophageal junction cancer: a single institute experience

Neoadjuvant/definitive radiotherapy in esophageal cancer

Abstract

Background: The aim of this study was to present our clinical experience as survival and failure outcomes in patients with locally advanced esophageal and gastro-oesophageal junction (GEJ) cancer who received neoadjuvant / curative radiotherapy (RT).

Methods: Twenty-eight patients with locally advanced stage (cT3-T4 any N and any T, N +) esophageal and GEJ cancer who received RT were retrospectively analyzed. Intensity-modulated radiotherapy (IMRT) was implemented to the patients in 25-33 fractions at a total dose of 45-59.4 Gy (median, 50 Gy).

 Results: Twelve of 28 patients were alive during up to the four-year follow-up period. The overall recurrence rate was 28% (8/28). The median overall survival (OS) and recurrent-free survival (RFS) were 17 and 8 months, respectively. The one-year OS and RFS were 65% and 28%, respectively. Surgery was performed on only 9 of 28 patients. Pathological complete response (pCR) was observed in 5 (55%) of 9 operated patients. In 19 non-operated patients, local control was achieved with RT in 90%, only 2 (10%) patients were locally progressed.

Conclusion: Multidisciplinary treatment is crucial in patients with locally advanced esophageal cancer with poor survival rates. Neoadjuvant/definitive RT is an effective treatment option for local control.