Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell Carcinoma

ObjectiveTo investigate the effect of different radiotherapy doses on the prognosis of patients with stage cT1-4N0M0 esophageal squamous cell carcinoma (ESCC) who received radical radio (chemo)therapy categorized into subgroups with different tumor local factors. MethodsA retrospective analysis was...

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Main Authors: Yan KONG, Qian DONG, Shuguang LI, Jinrui XU, Xiaohan ZHAO, Wenzhao DENG, Wenbin SHEN
Format: Article
Language:zho
Published: Magazine House of Cancer Research on Prevention and Treatment 2025-03-01
Series:Zhongliu Fangzhi Yanjiu
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Online Access:http://www.zlfzyj.com/cn/article/doi/10.3971/j.issn.1000-8578.2025.24.0721
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author Yan KONG
Qian DONG
Shuguang LI
Jinrui XU
Xiaohan ZHAO
Wenzhao DENG
Wenbin SHEN
author_facet Yan KONG
Qian DONG
Shuguang LI
Jinrui XU
Xiaohan ZHAO
Wenzhao DENG
Wenbin SHEN
author_sort Yan KONG
collection DOAJ
description ObjectiveTo investigate the effect of different radiotherapy doses on the prognosis of patients with stage cT1-4N0M0 esophageal squamous cell carcinoma (ESCC) who received radical radio (chemo)therapy categorized into subgroups with different tumor local factors. MethodsA retrospective analysis was conducted on 256 patients with clinically nonmetastatic esophageal squamous cell carcinoma. The optimal cutoff for tumor local factors was determined. The relationship between latest treatment efficacy and tumor local factors was analyzed, and independent indicators affecting patient overall survival (OS) were examined using multivariate analysis. The subgroup analysis was performed to determine the correlation between selected factors and radiation therapy doses. ResultsThe shorter the X-ray length of esophageal tumor lesion and the smaller the lesion canal wall thickness and gross tumor volume (GTV), the better the latest treatment efficacy of the patients (χ2=9.066, 10.310, 15.661, respectively, P=0.011, 0.006, P<0.001). Multivariate analysis results showed that GTV(P<0.001), radiation dose(P=0.038), and latest treatment efficacy(P<0.001) were independent predictors of the patients’ OS, and the latter two were also independent predictors of the patients’ progression-free survival (PFS) (P=0.033, <0.001). Subgroup analysis further showed that high doses of radiotherapy (over 60 Gy) resulted in good OS (χ2=5.040, 4.588, 5.400, P=0.025, 0.032, 0.020) and PFS (χ2=6.089, 4.353, 6.459, P=0.014, 0.037, 0.011) in the subgroup with maximum wall thickness below 3.7 cm, with esophageal lesions with GTV below 37.34 cm3, or not receiving simultaneous chemotherapy. ConclusionLocal tumor factors are important prognostic factors of ESCC patients treated with radical radio(chemo)therapy. Patients with thin lesion walls and small tumor volumes may greatly benefit from high doses of radiation (over 60 Gy).
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spelling doaj-art-be3bffda5bd0402aa380259e94de34b12025-08-20T02:48:39ZzhoMagazine House of Cancer Research on Prevention and TreatmentZhongliu Fangzhi Yanjiu1000-85782025-03-0152322523210.3971/j.issn.1000-8578.2025.24.072120240721Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell CarcinomaYan KONG0Qian DONG1Shuguang LI2Jinrui XU3Xiaohan ZHAO4Wenzhao DENG5Wenbin SHEN6Department of Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaDepartment of Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaDepartment of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaDepartment of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaDepartment of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaDepartment of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaDepartment of Radiotherapy, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, ChinaObjectiveTo investigate the effect of different radiotherapy doses on the prognosis of patients with stage cT1-4N0M0 esophageal squamous cell carcinoma (ESCC) who received radical radio (chemo)therapy categorized into subgroups with different tumor local factors. MethodsA retrospective analysis was conducted on 256 patients with clinically nonmetastatic esophageal squamous cell carcinoma. The optimal cutoff for tumor local factors was determined. The relationship between latest treatment efficacy and tumor local factors was analyzed, and independent indicators affecting patient overall survival (OS) were examined using multivariate analysis. The subgroup analysis was performed to determine the correlation between selected factors and radiation therapy doses. ResultsThe shorter the X-ray length of esophageal tumor lesion and the smaller the lesion canal wall thickness and gross tumor volume (GTV), the better the latest treatment efficacy of the patients (χ2=9.066, 10.310, 15.661, respectively, P=0.011, 0.006, P<0.001). Multivariate analysis results showed that GTV(P<0.001), radiation dose(P=0.038), and latest treatment efficacy(P<0.001) were independent predictors of the patients’ OS, and the latter two were also independent predictors of the patients’ progression-free survival (PFS) (P=0.033, <0.001). Subgroup analysis further showed that high doses of radiotherapy (over 60 Gy) resulted in good OS (χ2=5.040, 4.588, 5.400, P=0.025, 0.032, 0.020) and PFS (χ2=6.089, 4.353, 6.459, P=0.014, 0.037, 0.011) in the subgroup with maximum wall thickness below 3.7 cm, with esophageal lesions with GTV below 37.34 cm3, or not receiving simultaneous chemotherapy. ConclusionLocal tumor factors are important prognostic factors of ESCC patients treated with radical radio(chemo)therapy. Patients with thin lesion walls and small tumor volumes may greatly benefit from high doses of radiation (over 60 Gy).http://www.zlfzyj.com/cn/article/doi/10.3971/j.issn.1000-8578.2025.24.0721esophageal squamous cell carcinomano clinical metastasistumor local factorsradiation dosesubgroupprognosis
spellingShingle Yan KONG
Qian DONG
Shuguang LI
Jinrui XU
Xiaohan ZHAO
Wenzhao DENG
Wenbin SHEN
Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell Carcinoma
Zhongliu Fangzhi Yanjiu
esophageal squamous cell carcinoma
no clinical metastasis
tumor local factors
radiation dose
subgroup
prognosis
title Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell Carcinoma
title_full Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell Carcinoma
title_fullStr Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell Carcinoma
title_full_unstemmed Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell Carcinoma
title_short Influence of Local Tumor Factors and Radiotherapy Dose on Prognosis of Clinical Stage T1-4N0M0 Esophageal Squamous Cell Carcinoma
title_sort influence of local tumor factors and radiotherapy dose on prognosis of clinical stage t1 4n0m0 esophageal squamous cell carcinoma
topic esophageal squamous cell carcinoma
no clinical metastasis
tumor local factors
radiation dose
subgroup
prognosis
url http://www.zlfzyj.com/cn/article/doi/10.3971/j.issn.1000-8578.2025.24.0721
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