Dados do Trabalho

Título

Sociodemographic and clinical characterization of esophageal cancer patients treated with chemoradiation.

Introdução

Esophageal cancer is the eighth most incident and seventh most lethal cancer in Brazil, usually detected locally advanced and associate to poor prognosis. Chemoradiotherapy (CRT) is a frequent treatment. It is important to understand sociodemographic and clinical factors associated with EC in patients receiving CRT to find out options to improve patient care.

Objetivo

To characterize sociodemographic and clinical parameters in patients submitted to CRT.

Método

Retrospective analysis of medical records of the EC patients registered in Instituto Nacional de Cancer from January 2012 to December 2017

Resultados

232 were eligible to curative treatment with CRT. Mean age 59.5 ± years at diagnosis, gender masculine predominance (81.9%, 190) as ethnicity non-white (64.3%, 150) Smoking and alcohol consumption were identified as risk factors in 83,6% of the patients. Being married was frequent (61.2%, 119). Majority of patients had less than 8 years of education (54.3%,126). Clinical characteristics evaluated were symptoms, tumoral aspects, ocations and stage. Dysphagia was the most predominant clinical symptom (86,2 %, 200), most frequently for solid (46.1%, 107), liquid (25.4%, 59), pastry (14.7%, 34). Pain at presentation was common (39.2%, 91). Hematemesis and hoarseness as initial presentation were uncommon (3.9%, 9). Patients frequently have weight loss, median weight was 58 kg ±13.7 and median IMC was 21.1± 4.8. Performance status (PS) 1 was the most frequent (80.6%, 187). Epidermoid carcinoma was the most predominant histologic type (83.4%, 194) followed by adenocarcinoma (16.4%, 38). Histologic grade 2 was predominant (65.1%, 151). Stage grouping III was the most common (50%, 116), followed by stage II (45.3%, 105). Tumor location was predominantly middle thoracic portion (40.5%, 94). Median tumor extension was 6 ± 2.8, and tumoral aspects were partial stenosis (47%, 109), complet stenosis (32.3%, 75), ulcerative (56.9%, 132), infiltrative (39.2%,91, ) and vegetant (24.6%, 57). Trachea invasion and fistula were rare (3.4%, 8; 1.7%, 4). Definitive CT was the main treatment modality (84.6%) and trimodal treatment was performed in 15.4%. 45 Gy associated to carbotaxol was the most common scheme (75%). One third of patients achieved complete response (32.6%, 72), and partial response (19.5%, 43. 5 years median overall survival was 37.66 months and 5 years median disease free survival was 26.25 months.

Conclusão

Advanced disease and clinical challenging characteristcs impact in treatment outcome.

Palavras-chave

Esophageal cancer, chemoradiation