Comparison between continuous accelerated hyperfractionated and late-course accelerated hyperfractionated radiotherapy for esophageal carcinoma

Wang, Yang; Shi, Xiaoling; He, Shasha; Yao, Weichao; Wang, Yin; Guo, Xiaomao; Wu, Gen-di; Zhu, Long-Xiang; Liu, Tai-Fu

doi:10.1016/s0360-3016(02)02892-4

Cited by 39 publications

(36 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of LCAF RT were encouraging, with the 5-year survival rate varying from 26% to 33%. [4][5][6] Furthermore, patients with ESCC who were treated with concurrent LCAF RT and chemotherapy had a 5-year survival rate of 40% and a median survival time of 30.8 months in the study by Zhao et al 7 Therefore, this study indicated better survival in patients who received concurrent LCAF RT and chemotherapy than in those receiving LCAF RT alone. However, Grades 3-4 and Grade 5 toxicity rates were 46% and 6%, respectively, which were more severe than that in LCAF RT alone and might be mostly owing to chemotherapy.…”

mentioning

confidence: 71%

Phase II study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and pemetrexed and cisplatin for locally advanced oesophageal squamous cell carcinoma

Guo

et al. 2014

The British Journal of Radiology

View full text Add to dashboard Cite

Objective: To determine the clinical efficacy and toxicity of pemetrexed combined with low-dose cisplatin (CDDP) concurrent with late-course accelerated hyperfractionated (LCAF) intensity-modulated radiation therapy (IMRT) in patients with inoperable locally advanced oesophageal squamous cell carcinoma (ESCC). Methods: Patients with locally advanced ESCC (less than or equal to 75 years of age, clinical stages IIB-IVA and Karnofsky performance status $70) were enrolled into the study. A target group size of 22 was projected based on the estimation that 2-year overall survival (OS) would increase from 20% to 40%. Patients were treated with pemetrexed, low-dose CDDP and LCAF IMRT concurrently. The main objective of the study was for a 2-year OS, and the secondary objectives were progression-free survival (PFS), objective response, locoregional failure rate, and acute and late toxicities.Results: 25 patients were recruited from October 2008 to July 2011. The median OS was 21 months, with 2-and 5-year OS rates of 44% and 44%, respectively. The median PFS was 18.2 months. The objective response rate was 96% (24/25), with 11 complete responses and 13 partial responses. The locoregional failure rate was 16%. Grades 4 and 5 acute toxicity rates were 8% and 4%, respectively, while no Grade 3 or greater late toxicity was observed. Conclusion: The findings of this Phase II study indicated that the therapeutic regimen appears to achieve an excellent response rate and favourable survival for locally advanced ESCC. However, the severe acute side effects should be considered cautiously in further studies. Advances in knowledge: To our knowledge, this is the first study that introduced pemetrexed and low-dose CDDP combined with LCAF IMRT to treat locally advanced ESCC. The 5-year OS rate was as high as 44%, which was more favourable than other studies.Oesophageal carcinoma (EC) is one of the common malignant tumours all over the world, with China having a high incidence, for about 150,000 people die of it each year, accounting for nearly a quarter of all cancer deaths worldwide.1 According to a series of studies implemented by the Radiation Therapy Oncology Group (RTOG), such as the RTOG 8501 2 and RTOG 9405, 3 concurrent chemoradiotherapy (CCRT) was established as a standard approach for locally advanced EC; however, the prognosis was still poor with a median overall survival (OS) of 14.1 and 18.1 months, respectively. In order to improve the prognosis, late-course accelerated hyperfractionated (LCAF) radiotherapy (RT) was scheduled on oesophageal squamous cell carcinoma (ESCC) by Shi et al 4 in 1999. The results of LCAF RT were encouraging, with the 5-year survival rate varying from 26% to 33%. [4][5][6] Furthermore, patients with ESCC who were treated with concurrent LCAF RT and chemotherapy had a 5-year survival rate of 40% and a median survival time of 30.8 months in the study by Zhao et al. 7 Therefore, this study indicated better survival in patients who received concurrent LCAF RT and chemotherapy than in those rece...

show abstract

mentioning

confidence: 71%

Phase II study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and pemetrexed and cisplatin for locally advanced oesophageal squamous cell carcinoma

Guo

et al. 2014

The British Journal of Radiology

View full text Add to dashboard Cite

show abstract

“…The toxicities were slighter and response rates were encouraging in this trial in comparison with other previous studies. [3][4][5][6]8,9,[31][32][33] Given the overall size of this study, the results of the follow-up have been reviewed cautiously. However, the high response rate, milder toxicities and OS time when administering S-1, CDDP and LCAF RT were encouraging and support further Phase II or Phase III trial testing in locally advanced ESCC.…”

Section: Discussionmentioning

confidence: 99%

“…8 Since then, several results from retrospective and randomized studies have revealed similar conclusions. [9][10][11][12][13] Three recent independent meta-analyses from China demonstrated the therapeutical benefits of LCAF RT in comparison with conventional fractionation for EC. [14][15][16] Therefore, concurrent LCAF RT and chemotherapy have been widely accepted as a standard treatment for locally advanced ESCC in China.…”

Section: Introductionmentioning

confidence: 99%

Phase I study of concurrent selective lymph node late-course accelerated hyperfractionated radiotherapy and S-1 plus cisplatin for locally advanced oesophageal squamous cell carcinoma

Li¹,

Fu²,

Zhang³

et al. 2016

BJR

View full text Add to dashboard Cite

). In the initial five patients, two patients developed DLTs. As MTD was not reached, five additional patients were treated with the same dose level, and DLTs occurred in only one patient. Similar results were found in the last five patients. After CCRT, the objective response rates were 100% for primary tumours and 86.2% for metastatic lymph nodes, respectively. Totally, the observed Grade 3 toxicities during CCRT were leukopenia (20%), neutropenia (20%) and dermatitis (13.3%), and no Grade 4 toxicity occurred. The Kaplan-Meier-estimated overall and progression survival rates were 86.7% and 66.7% (1 year), 73.3% and 60% (2 years) and 73.3% and 60% (3 years). Conclusion:The concurrent SLN LCAF IMRT and chemotherapy with S-1 and CDDP was well tolerated and showed promising efficacy. The dose of S-1 in this regimen was recommended with 80 mg m 22 orally twice daily on Days 1-14 and Days 22-35. Advances in knowledge: CCRT with S-1 plus CDDP exhibited encouraging results with milder toxicities, high objective response rates and ideal overall survival time.

show abstract

“…Wang et al randomly assigned 101 patients with squamous cell cancer to receive either continuous accelerated hyperfractionated radiation (66 Gy) or late-course accelerated hyperfractionated radiation (68.4 Gy) (Wang et al, 2002). Compared with patients who received late-course accelerated hyperfractionated radiation, those treated with continuous accelerated hyperfractionated radiation had a significantly higher incidence of grade 3+ esophagitis (61% vs. 10%; P <.001); however, no benefit was seen in local control or survival.…”

Section: External-beam Therapymentioning

confidence: 99%

Nonsurgical Management of Esophageal Cancer

Safa¹,

Reda²

2012

Esophageal Cancer - Cell and Molecular Biology, Biomarkers, Nutrition and Treatment

View full text Add to dashboard Cite

Comparison between continuous accelerated hyperfractionated and late-course accelerated hyperfractionated radiotherapy for esophageal carcinoma

Cited by 39 publications

References 14 publications

Phase II study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and pemetrexed and cisplatin for locally advanced oesophageal squamous cell carcinoma

Phase II study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and pemetrexed and cisplatin for locally advanced oesophageal squamous cell carcinoma

Phase I study of concurrent selective lymph node late-course accelerated hyperfractionated radiotherapy and S-1 plus cisplatin for locally advanced oesophageal squamous cell carcinoma

Nonsurgical Management of Esophageal Cancer

Contact Info

Product

Resources

About