Survival in Patients Treated with Definitive Chemo-Radiotherapy for Non-Metastatic Esophageal Cancer in North-West Iran

Background: Areas of Iran have among the highest incidences of esophageal cancer in the world. Definitivechemo-radiotherapy (DCRT) is used for locally advanced esophageal cancer and for inoperable tumors asanalternative to surgical treatment. Materials and
Methods: This retrospective study was conducted in North-West Iran 2006-2011, including 267 consecutive patients with non-metastatic esophageal cancer. Eligibleinoperable patients were treated with DCRT or definitive radiotherapy (DRT) alone. Radiotherapy (RT) wasdelivered at 1.8-2 Gy/day for five consecutive days in a given week. Chemotherapy (CT) consisted of cisplatinand 5-fluorouracil.
Results: The median survival was 12.7 months with 1, 3 and 5 year survival rates of 55%,18% and 11%, respectively. On univariate analysis, relations with age at diagnosis (p=0.015), N-stage (p=0.04),total dose of RT (p=0.001), fraction (p<0.001), Gap status (p=0.025), chemotherapeutic regimens (P=0.027), and5-Fu Mg/m2 (P=0.004) were apparent. Comparing DCRT to DRT, there was a significant difference in survival.Multivariate analysis was performed for comparison between DCRT and DRT showed significant associationwith age group ≥65 to Conclusions: The survival rates of esophageal cancer treatedwith DCRT in North West of Iran is poor; therefore, early detection and improved treatment methods, withclinical trials are a high priority.