Patterns of toxic side effects and prognostic factors in concurrent chemoradiotherapy for esophageal cancer

SUMMARY Esophageal cancer is a leading cause of cancer-related mortality globally, characterized by poor prognosis and high recurrence rates. This study aimed to systematically evaluate the causes of death and treatment-related toxicities in esophageal cancer patients undergoing concurrent chemoradiotherapy (CCRT), to identify key prognostic factors. Clinical data from 79 patients were analyzed retrospectively, assessing survival outcomes, toxic side effects, and primary causes of death. Results revealed that local control failure and recurrence were the predominant causes of mortality, followed by distant metastasis and lymph node involvement. The overall survival rates at 1, 2, 3, and 4 years were 82.3%, 50.9%, 42.3%, and 40.0%, respectively, with a median survival time of 13 months. Radiation esophagitis and nausea/vomiting were the most common toxicities, though the majority of cases were mild. Tumor length and clinical stage were identified as significant independent prognostic factors, with shorter tumors and early-stage disease correlating with better survival. These findings emphasize the importance of early diagnosis, precise local control, and effective toxicity management in improving patient outcomes. This study provides critical insights into optimizing CCRT strategies, offering practical guidance for enhancing survival and quality of life in esophageal cancer patients.