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 ORIGINAL ARTICLE
Year : 2015  |  Volume : 52  |  Issue : 3  |  Page : 454-460

Treatment-associated severe thrombocytopenia affects survival rate in esophageal cancer patients undergoing concurrent chemoradiotherapy


1 Department of Internal Medicine, Divisions of Hematology-Oncology, Chang Gung Memorial Hospital, Keelung; Departments of Internal Medicine, Division of Hematology-Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan
2 Department of Internal Medicine, Divisions of Hematology-Oncology, Chang Gung Memorial Hospital, Keelung; College of Medicine, Chang Gung University, Taoyuan, Taiwan
3 Department of Internal Medicine, Divisions of Hematology-Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan
4 College of Medicine, Chang Gung University, Taoyuan; Radiation Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan

Correspondence Address:
C H Lai
Department of Internal Medicine, Divisions of Hematology-Oncology, Chang Gung Memorial Hospital, Keelung
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.176708

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Background: Esophageal cancer is commonly treated with surgery, concurrent chemoradiotherapy (CCRT), or a combination of both. The correlation between the hematological parameters during CCRT and early survival of esophageal cancer has not been fully evaluated. Materials And Methods: We analyzed the records of 65 esophageal cancer patients treated by CCRT between 2007 and 2010 retrospectively. The association between CCRT-associated myelosuppression, demographic variables, and survival rates were analyzed by univariate and multivariate analysis. Results: The univariate analysis showed that tumor extent of T3-4, a higher stage of tumor, a lower albumin level, grade 3 or higher anemia and thrombocytopenia, and interruptions in treatment affected survival rates. Further, the multivariate analysis revealed that stage IV (P = 0.030) is an independently negative prognostic factor for a one-year survival rate. Stage IV (P = 0.035), tumor extent of T3-4 (P = 0.002), and grade 3-4 thrombocytopenia (P = 0.015) are independently negative prognostic factors for a two-year survival rate. Conclusions: Severe decrease in platelet count during CCRT independently affects survival of esophageal cancer patients in addition to stage of the tumor.






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