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Concurrent three-dimensional conformal radiotherapy and chemotherapy for postoperative recurrence of mediastinal lymph node metastases in patients with esophageal squamous cell carcinoma: a phase 2 single-institution study.

Ma DY, Tan BX, Liu M, Li XF, Zhou YQ, Lu Y - Radiat Oncol (2014)

Bottom Line: Furthermore, the patients in group B simultaneously received weekly doses of cisplatin (30 mg/m(2)), and the survival outcomes and toxic effects were compared.However, there were no significant differences in the 5-year survival rates.However, intergroup differences in terms of late toxicity were not significant.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Lane, Chengdu, P,R, China. radyoulu@hotmail.com.

ABSTRACT

Aim: The aim of this study was to evaluate the effects of radiotherapy plus concurrent weekly cisplatin chemotherapy on the postoperative recurrence of mediastinal lymph node metastases in esophageal cancer patients.

Methods: Ninety-eight patients were randomly enrolled to receive either three-dimensional conformal radiotherapy alone (group A) or concurrent chemoradiotherapy (group B). A radiation dose of 62-70 Gy/31-35 fractions was delivered to the recurrent tumor. Furthermore, the patients in group B simultaneously received weekly doses of cisplatin (30 mg/m(2)), and the survival outcomes and toxic effects were compared.

Results: The response rate of group B (91.8%) was significantly greater than that of group A (73.5%) (χ(2) = 5.765, P = 0.016). The 1- and 3-year survival rates of group B (85.7% and 46.9%, respectively) were also greater than those of group A (69.4% and 28.6%, respectively). However, there were no significant differences in the 5-year survival rates. The numbers of patients who died of distant metastases in groups A and B were 13 (26.5%) and 5 (10.2%), respectively (χ(2) = 4.356, P = 0.036). Acute radiation-related esophagitis and granulocytopenia in group B was frequent. However, intergroup differences in terms of late toxicity were not significant.

Conclusions: Three-dimensional conformal radiotherapy (3DCRT) is a practical and feasible technique to treat the recurrence of mediastinal lymph node metastases of postoperative esophageal cancer. In addition, concurrent chemotherapy can increase local tumor control, decrease the distant metastasis rate, and increase the long-term survival rate.

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Comparison of the overall survival in both groups.
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Figure 1: Comparison of the overall survival in both groups.

Mentions: For surviving patients, the median follow-up period was 60 months (range, 8–63). The intention-to-treat analyses showed a median overall survival of 19 months in group A versus 35 months in group B (P = 0.051 by the log-rank test; hazard ratio, 0.76; 95% CI, 28–34) (Figure 1). According to our outcomes, the therapeutic regimen, radiation plus cisplatin-based chemotherapy, had an impressive contribution to the survival benefit in patients with advanced locoregional ESCC (Table 2 and Figure 1). Although there was no remarkable difference in the overall survival rate at five years between both groups (P = 0.051), the overall survival rates at 1 year and 3 years in group B were significantly better than those in group A (P = 0.032, P = 0.038) (Table 2).


Concurrent three-dimensional conformal radiotherapy and chemotherapy for postoperative recurrence of mediastinal lymph node metastases in patients with esophageal squamous cell carcinoma: a phase 2 single-institution study.

Ma DY, Tan BX, Liu M, Li XF, Zhou YQ, Lu Y - Radiat Oncol (2014)

Comparison of the overall survival in both groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927657&req=5

Figure 1: Comparison of the overall survival in both groups.
Mentions: For surviving patients, the median follow-up period was 60 months (range, 8–63). The intention-to-treat analyses showed a median overall survival of 19 months in group A versus 35 months in group B (P = 0.051 by the log-rank test; hazard ratio, 0.76; 95% CI, 28–34) (Figure 1). According to our outcomes, the therapeutic regimen, radiation plus cisplatin-based chemotherapy, had an impressive contribution to the survival benefit in patients with advanced locoregional ESCC (Table 2 and Figure 1). Although there was no remarkable difference in the overall survival rate at five years between both groups (P = 0.051), the overall survival rates at 1 year and 3 years in group B were significantly better than those in group A (P = 0.032, P = 0.038) (Table 2).

Bottom Line: Furthermore, the patients in group B simultaneously received weekly doses of cisplatin (30 mg/m(2)), and the survival outcomes and toxic effects were compared.However, there were no significant differences in the 5-year survival rates.However, intergroup differences in terms of late toxicity were not significant.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, 37 Guoxue Lane, Chengdu, P,R, China. radyoulu@hotmail.com.

ABSTRACT

Aim: The aim of this study was to evaluate the effects of radiotherapy plus concurrent weekly cisplatin chemotherapy on the postoperative recurrence of mediastinal lymph node metastases in esophageal cancer patients.

Methods: Ninety-eight patients were randomly enrolled to receive either three-dimensional conformal radiotherapy alone (group A) or concurrent chemoradiotherapy (group B). A radiation dose of 62-70 Gy/31-35 fractions was delivered to the recurrent tumor. Furthermore, the patients in group B simultaneously received weekly doses of cisplatin (30 mg/m(2)), and the survival outcomes and toxic effects were compared.

Results: The response rate of group B (91.8%) was significantly greater than that of group A (73.5%) (χ(2) = 5.765, P = 0.016). The 1- and 3-year survival rates of group B (85.7% and 46.9%, respectively) were also greater than those of group A (69.4% and 28.6%, respectively). However, there were no significant differences in the 5-year survival rates. The numbers of patients who died of distant metastases in groups A and B were 13 (26.5%) and 5 (10.2%), respectively (χ(2) = 4.356, P = 0.036). Acute radiation-related esophagitis and granulocytopenia in group B was frequent. However, intergroup differences in terms of late toxicity were not significant.

Conclusions: Three-dimensional conformal radiotherapy (3DCRT) is a practical and feasible technique to treat the recurrence of mediastinal lymph node metastases of postoperative esophageal cancer. In addition, concurrent chemotherapy can increase local tumor control, decrease the distant metastasis rate, and increase the long-term survival rate.

Show MeSH
Related in: MedlinePlus