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Cancers 2018, 10(8), 259; https://doi.org/10.3390/cancers10080259

Radiotherapy for T1N0M0 Esophageal Cancer: Analyses of the Predictive Factors and the Role of Endoscopic Submucosal Dissection in the Local Control

1
Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
2
Department of Gastroenterology and Hepatology Dermatology, Kyoto Prefectural University Graduate School of Medical Science, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
*
Author to whom correspondence should be addressed.
Received: 16 June 2018 / Revised: 31 July 2018 / Accepted: 1 August 2018 / Published: 3 August 2018
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Abstract

Several therapeutic options are available for clinical T1N0M0 thoracic esophageal squamous cell carcinoma (stage I ESCC); however, the studies on the treatment results are limited. This study assessed the outcomes of stage I ESCC treated with radiotherapy (RT), determined predictive factors, and evaluated the benefits of endoscopic submucosal dissection (ESD) combined with RT. We retrospectively analyzed the data of 50 patients (41 men, 9 women; median age, 66 years) with stage I ESCC treated with RT. The median total irradiation dose was 50 Gy. Elective nodal irradiation (ENI) was performed in 17 patients and ESD in 29 patients (ESD group). Forty-six patients concurrently received chemotherapy with RT. The median tumor length of ESD and non-ESD groups was 2.3 and 5 cm, respectively. The median follow-up was 33 months. The 3-year overall survival, disease-free survival (DFS), and local control (LC) rates were 77.3%, 61.1%, and 88.1%, respectively. Grade 3 adverse events occurred in 14 patients. T stage and tumor length were significant prognostic factors for 3-year DFS and 3-year LC, respectively. ESD appeared to be an important prognostic factor for LC. ENI and total irradiation dose above 50.4 Gy were not predictive factors. Our findings might help in treatment decisions for stage I ESCC. View Full-Text
Keywords: chemoradiation; endoscopic resection; ESD; stage I; prognostic factors; radiation; superficial esophageal cancer chemoradiation; endoscopic resection; ESD; stage I; prognostic factors; radiation; superficial esophageal cancer
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Suzuki, G.; Yamazaki, H.; Aibe, N.; Masui, K.; Shimizu, D.; Kimoto, T.; Nishimura, T.; Nakashima, A.; Takenaka, T.; Dohi, O.; Ishikawa, T.; Yamada, K. Radiotherapy for T1N0M0 Esophageal Cancer: Analyses of the Predictive Factors and the Role of Endoscopic Submucosal Dissection in the Local Control. Cancers 2018, 10, 259.

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