Prognostic effect of clinical staging for esophageal carcinoma patients with three-dimensional conformal radiotherapy

Objective: To study the prognostic factors in esophageal cancer patients after three- dimensional conf0rmal radiotherapy(3DCRT) using Cox proportional hazard model and to evaluate the validity of the clinical staging. Methods: Eight-one esophageal carcinoma patients treated by 3DCRT were analyzed retrospectively, and several factors including the local T staging of tumor, N staging and the clinical staging were analyzed using Cox proportional hazard model. The correlation of the local T staging of tumor and the clinical staging with prognosis was studied. Results: The 1-, 2-, 3- and 4-year overall survival rate was 67.9%, 45.7%, 40.5% and 30.9%, respectively. The 1-, 2-, 3-, 4-year local control rate was 83.0%, 76.1%, 73.9 % and 69.8 %, respectively. Multivariate analysis showed that the size of tumor, the local T staging of tumor, the clinical stage and esophageal GTVD95 were independent prognostic factors. There were significant differences between the local T staging of tumor and the clinical staging in terms of overall survival, local-regional control, distant metastasis-free survival and disease-free survival (all P<0.05). There were significant differences between stage III and stage IV in terms of overall survival, distant metastasis-free survival and disease-free survival(P=0.020,0.039,0.045), except for the local-regional control(P=0.155). The stage No had the same results with stage N1, and N2. Conclusions: The four-stage system is optimal for non-operative esophageal cancer in clinical staging and it can be used to predict prognosis. (authors)