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Jpn J Clin Oncol. 2017 May 1;47(5):393-400. doi: 10.1093/jjco/hyx021.

Clinical outcome of definitive radiation therapy for superficial esophageal cancer.

Author information

1
Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya.
2
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya.
3
Department of Clinical Oncology, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya.
4
Department of Endoscopy, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya.
5
Department of Radiology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.

Abstract

Objective:

To analyze the clinical outcome of concurrent chemoradiotherapy in superficial esophageal cancer patients.

Methods:

We retrospectively analyzed data for 123 patients with superficial esophageal cancer who received external beam radiotherapy without intracavitary brachytherapy plus systemic chemotherapy during 1998-2015. Elective nodal irradiation was not performed. The dosage to planning treatment volume was 60 Gy in 30 fractions. The main outcome measure was overall survival.

Results:

Patient characteristics were as follows: median age, 66 (41-83) years; male/female ratio, 106/17; squamous cell carcinoma/other, 122/1; cT1a/cT1b, 27/96; cervical esophagus/upper thoracic esophagus/middle thoracic esophagus/lower thoracic esophagus, 7/9/66/41 and concurrent chemoradiotherapy/radiotherapy alone, 100/23. Cisplatin and 5-fluorouracil were the most commonly used agents (85%). At the last follow-up (median 60.5 months), 91 (74%) patients were alive. Complete response was achieved in 116 (94.4%) patients. The 5-year overall survival, progression-free survival and local control rates were 77.0, 46.9 and 62.7%, respectively, similar to that in the elderly patients (P = 0.878, 0.754 and 0.648, respectively). There were 55 failures: 42 local, 10 regional and 3 distant failures. Nine local and seven regional failures developed out-of-field. Thirty-eight local failures (90%) were successfully salvaged, of which 30 (71%) were salvaged via endoscopic removal; only 2 regional failures (20%) were salvaged. Fifteen G3 acute toxicities occurred. One pneumonitis (G3), one pneumothorax (G3) and two pericardial effusion (G2) were the late toxicities observed. There were no G4 toxicities or treatment-related deaths.

Conclusions:

Concurrent chemoradiotherapy without intracavitary brachytherapy was effective and safe for superficial esophageal cancer, even in elderly patients.

KEYWORDS:

aged; chemoradiotherapy; elderly; esophageal neoplasms; lymphatic irradiation; toxicity

PMID:
28334837
DOI:
10.1093/jjco/hyx021
[Indexed for MEDLINE]

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