In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 4_suppl ( 2017-02-01), p. 142-142
Abstract:
142 Background: Extended field (EF) radiotherapy including regional nodes, has been adopted for the treatment of esophageal squamous cell carcinoma (ESCC), but it sometimes causes severe radiation-related adverse events. The purpose of this study is to compare local-field (LF) to EF radiotherapy administered as chemoradiotherapy (CRT) in early esophageal cancer. Methods: Selection criteria included histologically proven T1bN0M0 ESCC, performance status (PS) 0-1, adequate organ function and no other active malignancy. Data on patients who received CRT concurrently with 5-FU and cisplatin between Jan. 2000 and Dec. 2012 in our hospital were evaluated. All patients received radiotherapy at a dose of 60Gy without a planned break. The clinical target volume (CTV) of LF included gross tumor volume (GTV) plus 3-cm superior and inferior margins, and that of EF included GTV plus regional lymph nodes. Overall survivals (OS) were estimated with the Kaplan-Meier method and compared with the log-rank test. The Cox regression model was used for multivariate analysis. Adverse events were graded according to the CTCAE v.4.0. Results: The characteristics of the EF group (n = 120) and LF group (n = 79) are: Median age, 68.0 years and 65.0 years; male/female, 106/14 and 67/12; PS 0/1, 93/27 and 63/18; median tumor length, 40.6mm and 35.4mm, respectively. The complete response rates were 90.0% and 98.7%, respectively. The median follow-up periods were 103 months and 69 months, respectively. The 5-year overall and cause-specific survival rates were 74.5% and 90.6%, 89.5% and 91.8%, respectively. According to a multivariate analysis, EF was a significant negative prognostic factor for OS (hazard ratio = 2.88, p = 0.002) but not for cause-specific survival. Cardiopulmonary toxicities of grade 3 or greater were observed more frequently in the EF group (p = 0.035), with statistical significance. Treatment-related death occurred at 6.7% and 1.3%, respectively, in the two groups. Conclusions: It is suggested that radiation with LF may be better than EF in combination with concurrent chemotherapy in early esophageal cancer (T1bN0M0).
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.4_suppl.142
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
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