A Phase II Trial of Chemoradiotherapy for Stage I Esophageal Squamous Cell Carcinoma: Japan Clinical Oncology Group Study (JCOG9708)

Kato, Hoichi; Sato, Akihiro; Fukuda, Haruhiko; Kagami, Yoshikazu; Udagawa, Harushi; Togo, Akihiko; Ando, Nobutoshi; Tanaka, Otsuo; Sekiguchi, Masayuki; Yamana, Hideaki; Ishikura, Satoshi

doi:10.1093/jjco/hyp069

Cited by 270 publications

(217 citation statements)

References 12 publications

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“…In the present study, 28 patients who did not undergo additional OP showed only 3.5% of local relapse without any death caused by post-ESD complications. This result was better than the rates of previous reports (6,7) (Table 7). Moreover, the rate was better than the rate of the Kobe University Hospital study of CRT treatment for clinical stage I esophageal SQC (local relapse rate: 14%, n=21).…”

Section: Discussioncontrasting

confidence: 75%

“…Chemoradiotherapy (CRT) or radiotherapy (RT) has been recognized as a reliable, non-surgical standard treatment for local superficial lesions in the medically inoperable patients or for unresectable advanced lesions. A phase II trial (JCOG9708) was conducted to evaluate the efficacy and the safety of concurrent CRT using 5-fluorouracil (5-FU) plus cisplatin (CDDP) for clinical stage I esophageal SQC (6). The results of this study demonstrated that CRT showed a complete response rate (87.5%) and 70% 3-year relapse-free survival rate.…”

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confidence: 99%

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Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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Objective The standard treatment for submucosal esophageal cancer is esophagectomy or chemoradiotherapy (CRT). However, these treatment modalities could deteriorate the general condition and quality of life of the patients who are intolerant to invasive therapy. It is therefore important and beneficial to develop less invasive treatment protocols for these patients. Methods The study included 43 patients who were clinically suspected of mucosa or submucosal esophageal cancer but underwent endoscopic submucosal dissection (ESD) as a primary treatment, due to the patients' poor performance statuses and/or preferences for less invasive therapy. According to the pathological findings and patient's general condition, whether the patient underwent additional treatments or remained hospitalized without additional treatments was thereafter decided for each patient. We retrospectively analyzed the outcomes of these patients. Results Fifteen patients underwent additional surgery, 11 patients underwent CRT/radiation therapy (RT) and 17 patients were followed without additional treatments. During the 3-year follow-up period, the relapsefree survival rates in the patients who received or did not receive additional treatments were 88% and 64%, respectively (95% confidence interval, 0.45-0.76, p=0.04). The relapse-free and overall survival rates in the patients with additional treatments were equivalent or superior to those described in previous reports of the standard treatments. Preceding ESD contributed to reduce the local relapse significantly to approximately 3.5% and additional CRT-related toxicities. Conclusion Preceding ESD is very effective for the local control of cancer, and useful for histologically confirming the high-risk factors of relapse, such as ! submucosal layer 2 (SM2) invasion and lymphovascular involvements. ESD with additional therapy may be a promising strategy for optimizing the selection of therapy depending on the patient's general condition.

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Section: Discussioncontrasting

confidence: 75%

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confidence: 99%

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

et al. 2015

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“…Nevertheless, these encouraging reports have led to the further activation of several studies to assess the efficacy of definitive CRTx for patients with earlier stage squamous cell cancer. JCOG9708 trial (H. Kato et al, 2009) elucidated 2-year and 4-year SRs of 93% and 81%, respectively, which were comparable to those of the stage I SCC undergoing esophagectomy (The Japan Esophageal Society). Other investigators also reported a high complete response rate (88%) and 3-year SR (79%) in patients with stage I SCC by definitive CRTx (Minashi et al, 2006).…”

Section: Definitive Crtx For Resectable Ecmentioning

confidence: 83%

Multimodal Therapies for Upper Gastrointestinal Cancers – Past, Now, and Future

Shimoyama¹

2011

Current Cancer Treatment - Novel Beyond Conventional Approaches

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“…For example, neoadjuvant chemotherapy before curative surgery has been shown to improve the prognosis of patients with EC (13), and the clinical outcomes of definitive CRT are now similar to those of curative surgery (14). Furthermore, a new chemotherapeutic regimen involving 5-fluorouracil, cisplatin and docetaxel, and a new method of radiotherapy called intensity-modulated radiotherapy, are receiving increasing attention as more effective therapies against EC (15,16).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of PET-CT in the Diagnosis and Treatment of Recurrence After Esophageal Cancer Surgery

Kudou

Shiozaki

Fujiwara

et al. 2016

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Abstract. Aim The present study aimed to retrospectively investigate the utility of positron-emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography (PET-CT) in regular followEsophageal cancer (EC) is the eighth most common cancer worldwide, with an estimated 456,000 new cases in 2012 (3.2% of all cases), and the sixth most common cause of death from cancer, with an estimated 400,000 deaths (4.9% of all deaths)(1). Although several diagnostic modalities and multimodal therapies have been developed in recent years, the prognosis of patients with EC remains poor even when curative surgery is performed. Postoperative recurrence occurs in 78% of patients who undergo curative surgery for EC (2, 3). Recurrence of EC is regarded as a grave prognostic sign after curative surgery, with most patients dying due to the progression of their cancer. However, a few patients with postoperative recurrence have achieved long-term survival (4, 5). The development of more effective therapies or examinations is presumed to have improved the clinical outcomes of patients with recurrent EC. In order to achieve further improvements in the prognosis of these patients, the characteristics of recurrent cases that survive long-term, and prognostic factors for recurrent EC need to be elucidated in more detail.Positron-emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose, an analog of glucose, integrated with computed tomography (PET-CT) is a functional imaging technique based on increased glucose uptake and glycolysis by cancer cells. In Japan, EC was approved as an indication for the use of PET-CT under health insurance coverage in April 2006. PET-CT is now widely used and provides a sensitive and specific examination for the staging or diagnosis of recurrent lesions in various lips of cancer (6-8). Furthermore, a previous study showed that PET-CT was useful for the early detection of recurrence after esophagostomy, and contributed to a good prognosis through early detection of single recurrent tumors (5). Although the utility of PET-CT in EC has been reported, an appropriate method for applying PET-CT to follow-up after curative surgery for EC has not yet been established. In order to provide EC patients the best medical care, it is necessary to clarify the utility of PET-CT in postoperative follow-up.PET-CT was implemented at our Institution in March 2007. We have been conducting imaging observations for regular follow-up of patients who underwent curative surgery for EC in our Division using PET-CT since January 2008. The present study aimed to retrospectively investigate the 5473

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A Phase II Trial of Chemoradiotherapy for Stage I Esophageal Squamous Cell Carcinoma: Japan Clinical Oncology Group Study (JCOG9708)

Abstract: High CR proportion and survival proportion with mild toxicity suggest that this regimen could be considered as a candidate of new standard treatment to be compared with surgery in patients with Stage I ESCC.

Cited by 270 publications

References 12 publications

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

Endoscopic Submucosal Dissection (ESD) with Additional Therapy for Superficial Esophageal Cancer with Submucosal Invasion

Multimodal Therapies for Upper Gastrointestinal Cancers – Past, Now, and Future

Efficacy of PET-CT in the Diagnosis and Treatment of Recurrence After Esophageal Cancer Surgery

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