Journal List > Korean J Gastroenterol > v.59(4) > 1006937

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Lee, Park, Gwoo, Jung, Kim, Park, Moon, Kim, Kim, Park, and Jeong: Comparison of Treatments in Patients with Inoperable Stage IV Advanced Esophageal Cancer
Original Article
Alimentary Tract
The Korean Journal of Gastroenterology

The Korean Journal of Gastroenterology 2012; 59(4): 282-288.

Published online: 23 April 2012

DOI: https://doi.org/10.4166/kjg.2012.59.4.282

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

Gyu Jin Lee, Moo In Park, Sangeon Gwoo, Hyun Joo Jung, Joo Hoon Kim, Seun Ja Park, Won Moon, Hyung Hun Kim, Yang Soo Kim, Sung Dal Park1, Tae Sig Jeong2

Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.

1Department of Thoracic and Cardiovascular Surgery, Kosin University College of Medicine, Busan, Korea.

2Department of Therapeutic Radiology, Kosin University College of Medicine, Busan, Korea.

Correspondence to: Moo In Park, Department of Internal Medicine, Kosin University Gospel Hospital, 262 Gancheon-ro, Seo-gu, Busan 602-702, Korea. Tel:+82-51-990-6719, Fax: +82-51-990-3005, mipark@ns.kosinmed.or.kr

Received 11 August 2011       Revised 7 October 2011       Accepted 14 October 2011

Copyright © 2012 The Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Esophageal cancer, Drug therapy, Chemoradiotherapy, Radiotherapy, Best supportive care

Figures and Tables

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.
kjg-59-282-g001
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.
kjg-59-282-g002
Table 1
Clinical Characteristics of the Patients
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Values are presented as median (range) or n (%).

ECOG, Eastern Cooperative Oncology Group; LN, lymph node.

aTested by chi-square test.

Table 2
Response Rate and Toxicity in Palliative Treatment Group
kjg-59-282-i002

Values are presented as n (%).

Table 3
Comparison of Median Overall Survival between the Best Supportive Care Group and Palliative Treatment Group according to the Prognostic Variables
kjg-59-282-i003

ECOG, Eastern Cooperative Oncology Group.

aTested by log-rank test.

Table 4
Prognostic Variables for Survival Rates
kjg-59-282-i004

Notes

Financial support: None.

Conflict of interest: None.

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