Concurrent chemoradiotherapy for cervical esophageal squamous cell carcinoma: treatment results from a prospective observational study

• Published in: Diseases of the esophagus Vol. 31; no. 5
• Main Authors: Li, H-X, Liu, J, Cheng, Y, Liu, M-N, Fang, W-T, Lv, C-X
• Format: Journal Article
• Language: English
• Published: United States 01-05-2018
• Subjects: Adult; Aged; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - radiotherapy; Chemoradiotherapy - methods; Chemoradiotherapy - statistics & numerical data; China - epidemiology; Consolidation Chemotherapy - methods; Disease-Free Survival; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - mortality; Esophageal Neoplasms - radiotherapy; Esophageal Squamous Cell Carcinoma; Esophagus - pathology; Female; Humans; Male; Middle Aged; Neoplasm Staging; Outcome and Process Assessment (Health Care); Prospective Studies; Radiotherapy, Conformal - methods; Radiotherapy, Intensity-Modulated - methods; China
• ISSN: 1120-8694; 1442-2050
• DOI: 10.1093/dote/dox144

A prospective observational study was performed to evaluate the results of treatment with concurrent chemoradiotherapy (CCRT) in patients with cervical esophageal squamous cell carcinoma (CESCC). Patients had CESCC, no distant metastasis, were 18-75 years old, and had PS 0-2. Radiotherapy (RT) was administered as either three-dimensional conformal radiation therapy (3D-CRT) or intensity-modulated radiation therapy (IMRT) with a total dose of 60 Gy/30 fractions. All patients were treated with platinum-based doublet concurrent chemotherapeutic regimens. CCRT was followed by 2-3 cycles of consolidation chemotherapy. The endpoints were overall survival (OS), progression-free survival (PFS), toxicities, and failure patterns. Ninety-two patients were enrolled from March 2007 to July 2014. The median follow-up time was 34 months. For all patients, the 3-year OS was 49.8% (median OS: 36 months, 95% CI: 24.963-47.051), and the 3-year PFS was 42.1%, (median PFS: 25 months, 95% CI: 17.097-32.903). Treatment failures occurred in 54 patients, including 30 cases (32.6%) with locoregional failure alone, 14 cases (15.2%) with distant metastasis alone, and 10 cases (10.9%) with both locoregional failure and distant metastasis. There were 51 (55.4%) and 3 cases (3.3%) of grade 3 and grade 5 radiation esophagitis, respectively. One patient (1%) had grade 5 laryngeal edema. Overall, CCRT has tolerable acute toxicities, and this regimen is an option for the treatment of patients with CESCC.