Korean J Gastroenterol.  2012 Apr;59(4):282-288. 10.4166/kjg.2012.59.4.282.

Comparison of Treatments in Patients with Inoperable Stage IV Advanced Esophageal Cancer

• Lee GJ
• Park MI
• Gwoo S
• Jung HJ
• Kim JH
• Park SJ
• Moon W
• Kim HH
• Kim YS
• Park SD
• Jeong TS

• KMID: 1364831
• DOI: http://doi.org/10.4166/kjg.2012.59.4.282

Abstract

BACKGROUND/AIMS
The aim of this study was to compare palliative treatments such as chemotherapy, chemoradiotherapy or radiotherapy with best supportive care in patients with inoperable advanced esophageal cancer.
METHODS
A total of 67 patients with inoperable advanced esophageal cancer visiting Kosin University Gospel Hospital between January 2000 and July 2010 were included in a retrospective analysis. Patients were categorized as having palliative treatment or best supportive care to compare their prognosis.
RESULTS
The median survival was 6.4 months in 67 patients. There was significant difference in median survival between the palliative and best supportive treatment (9.8 months vs. 4.5 months, p=0.01). The patients who underwent palliative treatment had superior 1-year and 3-year overall survival rate than those with best supportive treatment (27%, 10% vs. 5%, 5%, respectively). The 1-year and 3-year overall survival rate of palliative treatment was 18% (1-year overall survival rate) in chemotherapy, 33% (1-year overall survival rate) in radiotherapy, 45% and 9% in concurrent chemoradiotherapy, and 20% and 20% in sequential chemoradiotherapy, respectively.
CONCLUSIONS
These results may suggest that palliative treatments are more effective than best supportive care. Further prospective studies are still needed to elucidate beneficial effect of palliative treatments on inoperable advanced esophageal cancer.

Keyword

Esophageal cancer; Drug therapy; Chemoradiotherapy; Radiotherapy; Best supportive care

MeSH Terms

Aged
Aged, 80 and over
Combined Modality Therapy
Esophageal Neoplasms/mortality/*therapy
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
*Palliative Care
Prognosis
Retrospective Studies

Figure

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  Fig. 1 Kaplan-Meier overall survival curve between the best supportive care group and palliative treatment group. The cumulative survival rate of the palliative treatment group (solid line) was significantly better than that of the conservative best supportive care group (stippled line) in the stage IV esophageal cancer.

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  Fig. 2 Kaplan-Meier overall survival curve according to the treatment modalities in palliative treatment group. The cumulative survival rate of each subgroup was not significantly different. CTx, Chemotherapy; RTx, Radiotherapy; CCRTx, Concurrent chemoradiotherapy; SCRTx, Sequential chemoradiotherapy.

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