Cargando…

Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma

BACKGROUND: We compared the efficacy, safety, and costs of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) for the neoadjuvant treatment of esophageal cancer. MATERIALS AND METHODS: Overall, 110 patients with esophageal cancer treated with neoadjuvant chemoradi...

Descripción completa

Detalles Bibliográficos
Autores principales: Lyu, Jiahua, Liu, Tao, Li, Tao, Li, Fang, Wang, Qifeng, Wang, Jie, Han, Yongtao, Wang, Junchao, Zhang, Jun, Peng, Lin, Lang, Jinyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639169/
https://www.ncbi.nlm.nih.gov/pubmed/31119872
http://dx.doi.org/10.1002/cam4.2250
_version_ 1783436409477005312
author Lyu, Jiahua
Liu, Tao
Li, Tao
Li, Fang
Wang, Qifeng
Wang, Jie
Han, Yongtao
Wang, Junchao
Zhang, Jun
Peng, Lin
Lang, Jinyi
author_facet Lyu, Jiahua
Liu, Tao
Li, Tao
Li, Fang
Wang, Qifeng
Wang, Jie
Han, Yongtao
Wang, Junchao
Zhang, Jun
Peng, Lin
Lang, Jinyi
author_sort Lyu, Jiahua
collection PubMed
description BACKGROUND: We compared the efficacy, safety, and costs of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) for the neoadjuvant treatment of esophageal cancer. MATERIALS AND METHODS: Overall, 110 patients with esophageal cancer treated with neoadjuvant chemoradiotherapy from October 2002 to July 2017 were retrospectively included and divided into a HFRT group (42 patients received 30 Gray [Gy]/10 fractions for 2 weeks) and a CFRT group [68 patients received 40 Gy/20 fractions for 4 weeks]. Concurrent chemotherapy comprised cisplatin combined with either 5‐FU or taxane. Surgery was performed 3‐8 weeks after radiotherapy. We compared the outcomes, adverse events, and costs between the two groups. RESULTS: Pathological downstaging was achieved in 78.6% of the HFRT group and 83.8% of the CFRT group (P = 0.612). Compared with the CFRT group, the HFRT group had similar pathological complete response (pCR) (33.3% vs 35.3%; P = 0.834), median overall survival (OS) (40.8 months vs 44.9 months; P = 0.772) and progression free survival (32.7 months vs 35.4 months; P = 0.785). The perioperative complication rates were also similar between the groups, but the treatment time and costs were significantly reduced in the HFRT group (P < 0.05). Finally, multivariate analysis identified cN0 stage, pathological downstaging and pCR as independent predictors of better OS. CONCLUSION: Preoperative HFRT is effective and safe for esophageal cancer. Moreover, it is similar to CFRT in terms of overall survival and toxicity and is cost effective and less time consuming.
format Online
Article
Text
id pubmed-6639169
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-66391692019-07-29 Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma Lyu, Jiahua Liu, Tao Li, Tao Li, Fang Wang, Qifeng Wang, Jie Han, Yongtao Wang, Junchao Zhang, Jun Peng, Lin Lang, Jinyi Cancer Med Clinical Cancer Research BACKGROUND: We compared the efficacy, safety, and costs of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) for the neoadjuvant treatment of esophageal cancer. MATERIALS AND METHODS: Overall, 110 patients with esophageal cancer treated with neoadjuvant chemoradiotherapy from October 2002 to July 2017 were retrospectively included and divided into a HFRT group (42 patients received 30 Gray [Gy]/10 fractions for 2 weeks) and a CFRT group [68 patients received 40 Gy/20 fractions for 4 weeks]. Concurrent chemotherapy comprised cisplatin combined with either 5‐FU or taxane. Surgery was performed 3‐8 weeks after radiotherapy. We compared the outcomes, adverse events, and costs between the two groups. RESULTS: Pathological downstaging was achieved in 78.6% of the HFRT group and 83.8% of the CFRT group (P = 0.612). Compared with the CFRT group, the HFRT group had similar pathological complete response (pCR) (33.3% vs 35.3%; P = 0.834), median overall survival (OS) (40.8 months vs 44.9 months; P = 0.772) and progression free survival (32.7 months vs 35.4 months; P = 0.785). The perioperative complication rates were also similar between the groups, but the treatment time and costs were significantly reduced in the HFRT group (P < 0.05). Finally, multivariate analysis identified cN0 stage, pathological downstaging and pCR as independent predictors of better OS. CONCLUSION: Preoperative HFRT is effective and safe for esophageal cancer. Moreover, it is similar to CFRT in terms of overall survival and toxicity and is cost effective and less time consuming. John Wiley and Sons Inc. 2019-05-22 /pmc/articles/PMC6639169/ /pubmed/31119872 http://dx.doi.org/10.1002/cam4.2250 Text en © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Lyu, Jiahua
Liu, Tao
Li, Tao
Li, Fang
Wang, Qifeng
Wang, Jie
Han, Yongtao
Wang, Junchao
Zhang, Jun
Peng, Lin
Lang, Jinyi
Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma
title Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma
title_full Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma
title_fullStr Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma
title_full_unstemmed Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma
title_short Comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma
title_sort comparison  of  efficacy, safety, and costs between neoadjuvant hypofractionated radiotherapy and conventionally fractionated radiotherapy for esophageal carcinoma
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639169/
https://www.ncbi.nlm.nih.gov/pubmed/31119872
http://dx.doi.org/10.1002/cam4.2250
work_keys_str_mv AT lyujiahua comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT liutao comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT litao comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT lifang comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT wangqifeng comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT wangjie comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT hanyongtao comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT wangjunchao comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT zhangjun comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT penglin comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma
AT langjinyi comparisonofefficacysafetyandcostsbetweenneoadjuvanthypofractionatedradiotherapyandconventionallyfractionatedradiotherapyforesophagealcarcinoma