Clinical outcomes of radiotherapy for esophageal cancer between 2004 and 2008: the second survey of the Japanese Radiation Oncology Study Group (JROSG)

Background: This second questionnaire-based survey was performed to determine the clinical results of definitive esophageal cancer treatment with radiotherapy (RT) or chemoradiotherapy (CRT) between 2004 and 2008. Materials/methods: Clinical results of definitive RT for patients were collected from major Japanese institutions. Patients were classified into three groups: (A) stage I, (B) resectable stages II–III, (C) unresectable stages III–IVA. For group A, all patients treated with RT alone or CRT were included. For groups B and C, only those treated with CRT were included. Results: In total, 990 patients (group A 259, group B 333, group C 398 patients) were included from 11 institutions. In group A, 199 patients (78 %) were treated with CRT, and 60 patients (23 %) received RT alone. In groups B and C, 420 patients (57 %) were treated with full-dose cisplatin/5-FU, and 181 patients (25 %) with low-dose protracted-infusion cisplatin/5-FU. The median and range of the 5-year overall survival rate were 73 % (40–94 %) for group A, 40 % (0–57 %) for group B, and 18 % (6–26 %) for group C, respectively. The 5-year overall survival rates were consistently good for five high-volume centers where more than 20 patients/year with esophageal cancer were treated definitively as compared with the remaining six medium-volume centers (5–15 patients/year). The median and range of the incidence of grade ≥3 late toxicities were 10 % and 6–22 %, respectively. Conclusions: A wide disparity in 5-year overall survival rates among the institutions was still apparent in the second survey for groups A and B.