Preoperative Concurrent Radiochemotherapy for Locally Advanced Esophageal Cancer: Treatment Outcome and Prognostic Factors.
- Author:
Haeyoung KIM
1
;
Yong Chan AHN
;
Kwan Min KIM
;
Jhingook KIM
;
Young Mog SHIM
;
Young Hyuck IM
Author Information
1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ycahn@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Esophageal cancer;
Preoperative treatment;
Concurrent radio-chemotherapy
- MeSH:
Chemoradiotherapy*;
Cisplatin;
Disease-Free Survival;
Drug Therapy;
Esophageal Neoplasms*;
Esophagectomy;
Humans;
Lymph Nodes;
Neoplasm Metastasis;
Polymerase Chain Reaction;
Radiotherapy;
Recurrence;
Treatment Outcome*
- From:The Journal of the Korean Society for Therapeutic Radiology and Oncology
2007;25(3):160-169
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study reports the results of the use of preoperative concurrent radiochemotherapy (CRCT) for the treatment of locoregionally advanced esophageal cancer. MATERIALS AND METHODS: From 1998 through 2005, 61 patients with intrathoracic esophageal cancer at stages II-IVB (without distant organ metastasis and presumed to be respectable) received preoperative CRCT. CRCT consisted of radiotherapy (45 Gy /25 fractions /5 weeks) and FP chemotherapy (5-FU 1 g/m2/day, days 1-4 and 29-32, Cisplatin 60 mg/m2/day, days 1 and 29). An esophagectomy was planned in 4~6 weeks after the completion of CRCT. RESULTS: There were two treatment-related deaths. Among the 61 patients, 53 patients underwent surgery and 17 patients achieved a pathological complete response (pCR). The overall survival (OS) rates of all 61 patients at 2 and 5 years were 59.0% and 38.0%, respectively. The rates of OS and disease-free survival (DFS) of the surgically resected patients at 2 and 5 years were 61.6%, 40.1% and 53.3%, 41.8%, respectively. By univariate analysis, achieviement of pCR and a clinically uninvolved distant lymph node (cM0) were favorable prognostic factors for OS and DFS. There were 27 patients that experienced a relapse-a locoregional relapse occurred in 5 patients, a distant metastasis occurred in 12 patients and combined failure occurred in 10 patients. CONCLUSION: The results of the current study are favorable. pCR and an uninvolved distant lymph node were found to be favorable prognostic factors.
