The Treatment Outcomes of Patients with Cervical Esophageal Carcinoma Undergoing Definitive Chemoradiotherapy: A Multi-Institutional Analysis TROD 01-005.

To investigate the clinical outcomes of cervical esophageal carcinoma patients treated with definitive chemoradiotherapy (CRT). The clinical data of 180 patients received concurrent CRT between April 2005 and September 2021 at 17 institutions were retrospectively analyzed. All patients were treated with curative intent CRT. Only patients treated with definitive intent, and squamous histology were analyzed. Patients who were treated with adjuvant or neoadjuvant setting or adenocarcinoma histology were excluded. The primary endpoint was LC, and the secondary endpoints were PFS and OS. Median age was 56 years (range; 26-87 years). Mean tumor size was 4.9 ± 2.1 cm. Majority of patients (60.6%) are female, had extensive T stage (78.9%), and regional lymph node metastasis (60.6%). Median fraction and total radiation doses were 2 Gy (range, 1.8-2.3 Gy) and 60 Gy (45-72 Gy), respectively delivered in median 30 fractions (range, 23-38 fr). Thirty-six patients (20%) were treated with 3-D conformal radiotherapy (RT) and 144 patients (80%) received intensity modulated RT (IMRT). Majority of the patients (49.4%) received concurrent cisplatin-based chemotherapy with a median 5 cycles (range, 1-8). Median follow-up was 20.7 months (range, 2.4-155.2 months). The 2-year OS and PFS rates were 58.7% and 47%, respectively. The 2-year LC was 69.5%. In univariate analysis ECOG performance score (p:0.01) and treatment response (p<0.001) were significant prognostic factors for OS and PFS. In multivariate analysis ECOG score 2 (HR=1.94, 95%CI, 1.18-3.18, p=0.009) and incomplete treatment response (HR=4.42, 95%CI, 2.80-6.99, p<0.001) were independent predictors for worse OS. In multivariate analysis ECOG score 2 (HR=1.73, 95%CI, 1.0.7-3.79, p=0.003) and incomplete treatment response (HR=4.42, 95%CI, 2.88-6.74, p<0.001) were independent predictors for worse PFS. We found that CRT is a safe and effective treatment modality in patients with cervical esophageal carcinoma. The treatment response and patient performance status were predictive for survival. Further prospective studies with larger cohorts are warranted to confirm our findings. [ABSTRACT FROM AUTHOR]