Long-term results of definitive chemoradiotherapy for unresectable locally advanced esophageal squamous cell carcinoma
Open Access
- 2 December 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Radiation Research
- Vol. 62 (1), 142-148
- https://doi.org/10.1093/jrr/rraa110
Abstract
Purpose The present study aimed to evaluate the long-term results of definitive chemoradiotherapy (CRT) for unresectable locally advanced esophageal squamous cell carcinoma (LA-ESCC). Materials and methods We analyzed eighty patients with unresectable LA-ESCC, who underwent definitive CRT between 2001 and 2014. The 5-year overall survival (OS), cause-specific survival (CSS), and progression-free survival (PFS) rates were calculated, and we investigated the prognostic factors and adverse events. Results The median age was 66 years (range, 41–83 years). Histologically, all patients had squamous cell carcinoma. The most common tumor site was the middle thoracic esophagus in 43 (54%) patients. According to the eighth edition of the Union for International Cancer Control TNM classification, sixty-six patients (83%) had T4 disease, 59 (74%) had regional lymph node (LN) metastases, and 35 (44%) had distant LN metastases beyond the regional LN (M1 LYM) disease. Forty-five (56%) and 35 (44%) patients belong to clinical stages IVA and IVB, respectively. The median follow-up period for survivors was 86 months. The 5-year OS, CSS, and PFS rates were 20.2%, 25.7%, and 18.4%, respectively. On univariate analysis, only the performance status score was significantly associated with better overall survival (p = 0.026). Grade 3 or higher late adverse events were observed in 12 (15%) patients, and these included cardiopulmonary adverse events in 6 (8%) patients. Treatment-related death occurred in 3 (4%) patients. Conclusion We showed the long-term results of definitive CRT for unresectable LA-ESCC. The survivals are still poor and new treatment strategies need to be developed.Keywords
This publication has 21 references indexed in Scilit:
- Treatment and clinical outcome of clinical T4 esophageal cancer: A systematic reviewAnnals of Gastroenterological Surgery, 2018
- Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trialThe Lancet Oncology, 2015
- Randomized study of low‐dose versus standard‐dose chemoradiotherapy for unresectable esophageal squamous cell carcinoma (JCOG0303)Cancer Science, 2015
- Phase II Study of Chemoradiotherapy With 5-Fluorouracil and Cisplatin for Stage II–III Esophageal Squamous Cell Carcinoma: JCOG Trial (JCOG 9906)International Journal of Radiation Oncology*Biology*Physics, 2011
- A Randomized Trial Comparing Postoperative Adjuvant Chemotherapy with Cisplatin and 5-Fluorouracil Versus Preoperative Chemotherapy for Localized Advanced Squamous Cell Carcinoma of the Thoracic Esophagus (JCOG9907)Annals of Surgical Oncology, 2011
- A phase I/II study of nedaplatin and 5-fluorouracil with concurrent radiotherapy in patients with T4 esophageal cancer: Japan Clinical Oncology Group trial (JCOG 9908)Esophagus, 2005
- Phase II Study of Cisplatin and 5-Fluorouracil with Concurrent Radiotherapy in Advanced Squamous Cell Carcinoma of the Esophagus: a Japan Esophageal Oncology Group (JEOG)/Japan Clinical Oncology Group Trial (JCOG9516)Japanese Journal of Clinical Oncology, 2004
- Surgery Plus Chemotherapy Compared With Surgery Alone for Localized Squamous Cell Carcinoma of the Thoracic Esophagus: A Japan Clinical Oncology Group Study—JCOG9204Journal of Clinical Oncology, 2003
- Chemoradiotherapy of Locally Advanced Esophageal CancerJAMA, 1999
- Combined Chemotherapy and Radiotherapy Compared with Radiotherapy Alone in Patients with Cancer of the EsophagusThe New England Journal of Medicine, 1992