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Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy

PURPOSE: Locally advanced esophageal cancers are generally treated with neoadjuvant chemoradiotherapy, followed by surgery in operable candidates. However, even if the patients were diagnosed as operable disease, surgery could not be performed on patients with poor condition or other comorbidity. In...

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Autores principales: Kim, Dae-Eun, Kim, Uh-Jin, Choi, Won-Young, Kim, Mi-Young, Kim, Seung-Hun, Kim, Min-Jee, Shim, Hyun-Jeong, Hwang, Jun-Eul, Bae, Woo-Kyun, Chung, Ik-Joo, Nam, Taek-Keun, Na, Kook-Joo, Cho, Sang-Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Cancer Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893325/
https://www.ncbi.nlm.nih.gov/pubmed/24454000
http://dx.doi.org/10.4143/crt.2013.45.4.276
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author Kim, Dae-Eun
Kim, Uh-Jin
Choi, Won-Young
Kim, Mi-Young
Kim, Seung-Hun
Kim, Min-Jee
Shim, Hyun-Jeong
Hwang, Jun-Eul
Bae, Woo-Kyun
Chung, Ik-Joo
Nam, Taek-Keun
Na, Kook-Joo
Cho, Sang-Hee
author_facet Kim, Dae-Eun
Kim, Uh-Jin
Choi, Won-Young
Kim, Mi-Young
Kim, Seung-Hun
Kim, Min-Jee
Shim, Hyun-Jeong
Hwang, Jun-Eul
Bae, Woo-Kyun
Chung, Ik-Joo
Nam, Taek-Keun
Na, Kook-Joo
Cho, Sang-Hee
author_sort Kim, Dae-Eun
collection PubMed
description PURPOSE: Locally advanced esophageal cancers are generally treated with neoadjuvant chemoradiotherapy, followed by surgery in operable candidates. However, even if the patients were diagnosed as operable disease, surgery could not be performed on patients with poor condition or other comorbidity. In this case, definitive chemoradiotherapy (dCRT) is the other option for localized esophageal cancer. Therefore, the purpose of this study was to evaluate the efficacy and clinical prognostic factors for dCRT in locally advanced esophageal cancer. MATERIALS AND METHODS: We conducted a review of patients who received dCRT for locally advanced squamous esophageal cancer from 2004 to 2010, focusing on stages III and IVa. All patients received at least two cycles of platinum-based chemotherapy during radiation, and all tumor burdens were included in the radiation field. The treatment results were analyzed for patterns of failure and prognostic factors associated with survival. RESULTS: In total, 63 patients were enrolled in this study. The overall response rate was 84.1%. Relief from dysphagia after dCRT was achieved in 48 patients. The most frequent failure was local recurrence. The median overall survival (OS) was 23.0 months, and the 2-year survival rate was 45.4%. Similar results were observed for elderly study patients. Significant prognostic factors for OS were duration of smoking, high grade of dysphagia (score of 3 or 4), and shorter duration of progression-free and dysphagia-free survival. Maintenance chemotherapy after dCRT did not influence OS. However, "good risk" patients receiving maintenance chemotherapy showed better OS than those who did not receive maintenance chemotherapy (30.4 months vs. 12.0 months, p=0.002). CONCLUSION: dCRT has a major role in improving survival and palliation of dysphagia in inoperable advanced esophageal cancer, even in elderly patients. Maintenance chemotherapy after dCRT may be effective in prolonging survival in "good risk" patients.
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spelling pubmed-38933252014-01-17 Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy Kim, Dae-Eun Kim, Uh-Jin Choi, Won-Young Kim, Mi-Young Kim, Seung-Hun Kim, Min-Jee Shim, Hyun-Jeong Hwang, Jun-Eul Bae, Woo-Kyun Chung, Ik-Joo Nam, Taek-Keun Na, Kook-Joo Cho, Sang-Hee Cancer Res Treat Original Article PURPOSE: Locally advanced esophageal cancers are generally treated with neoadjuvant chemoradiotherapy, followed by surgery in operable candidates. However, even if the patients were diagnosed as operable disease, surgery could not be performed on patients with poor condition or other comorbidity. In this case, definitive chemoradiotherapy (dCRT) is the other option for localized esophageal cancer. Therefore, the purpose of this study was to evaluate the efficacy and clinical prognostic factors for dCRT in locally advanced esophageal cancer. MATERIALS AND METHODS: We conducted a review of patients who received dCRT for locally advanced squamous esophageal cancer from 2004 to 2010, focusing on stages III and IVa. All patients received at least two cycles of platinum-based chemotherapy during radiation, and all tumor burdens were included in the radiation field. The treatment results were analyzed for patterns of failure and prognostic factors associated with survival. RESULTS: In total, 63 patients were enrolled in this study. The overall response rate was 84.1%. Relief from dysphagia after dCRT was achieved in 48 patients. The most frequent failure was local recurrence. The median overall survival (OS) was 23.0 months, and the 2-year survival rate was 45.4%. Similar results were observed for elderly study patients. Significant prognostic factors for OS were duration of smoking, high grade of dysphagia (score of 3 or 4), and shorter duration of progression-free and dysphagia-free survival. Maintenance chemotherapy after dCRT did not influence OS. However, "good risk" patients receiving maintenance chemotherapy showed better OS than those who did not receive maintenance chemotherapy (30.4 months vs. 12.0 months, p=0.002). CONCLUSION: dCRT has a major role in improving survival and palliation of dysphagia in inoperable advanced esophageal cancer, even in elderly patients. Maintenance chemotherapy after dCRT may be effective in prolonging survival in "good risk" patients. Korean Cancer Association 2013-12 2013-12-31 /pmc/articles/PMC3893325/ /pubmed/24454000 http://dx.doi.org/10.4143/crt.2013.45.4.276 Text en Copyright © 2013 by the Korean Cancer Association http://creativecommons.org/licenses/by-nc/3.0/ This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Dae-Eun
Kim, Uh-Jin
Choi, Won-Young
Kim, Mi-Young
Kim, Seung-Hun
Kim, Min-Jee
Shim, Hyun-Jeong
Hwang, Jun-Eul
Bae, Woo-Kyun
Chung, Ik-Joo
Nam, Taek-Keun
Na, Kook-Joo
Cho, Sang-Hee
Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy
title Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy
title_full Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy
title_fullStr Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy
title_full_unstemmed Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy
title_short Clinical Prognostic Factors for Locally Advanced Esophageal Squamous Carcinoma Treated after Definitive Chemoradiotherapy
title_sort clinical prognostic factors for locally advanced esophageal squamous carcinoma treated after definitive chemoradiotherapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893325/
https://www.ncbi.nlm.nih.gov/pubmed/24454000
http://dx.doi.org/10.4143/crt.2013.45.4.276
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