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

Abstract

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.

Definitive Chemoradiotherapy with Docetaxel, Cisplatin, and 5-Fluorouracil for Advanced Cervical Esophageal Cancer: A Medium-Term Outcome

“…The5-fluorouracil and platinum-based chemotherapy (FP-RT) has been used for dCRT of the cervical esophagus in several reports. These previous studies suggest that the OS rate after 5-year was 21%-55% (Burmeister et al, 2000;Yamanda et al, 2006;Uno et al, 2007;Gkika et al, 2014;Zhang et al, 2015;Zenda et al, 2016;Ito et al, 2017;Li et al, 2017). As evident from this study, the degree of disease progression in patients was far advanced and the survival rate was also satisfactory.…”

<p>Clinical results of intensity-modulated radiotherapy for 250 patients with cervical and upper thoracic esophageal carcinoma</p>

“…Surgery alone has been reported ineffective in patients with cervical esophageal cancer. Contrastively, radiotherapy and radiotherapy combined with surgery have better therapeutic efficacy 9,14. In our study, 54 patients (24.5%) had cervical esophageal cancer.…”

“…Intensity-modulated radiotherapy (IMRT), a radiotherapeutic modality with high conformality and mild side effects, is often used for the treatment of cervical and upper thoracic esophageal cancer. Some studies demonstrate the advantages of IMRT in cervical esophageal cancer 8,9. However, few studies have investigated the outcomes of IMRT in patients with upper thoracic esophageal cancer, and the data regarding the clinical efficacy, failure patterns and prognostic factors for cervical and upper thoracic esophageal cancer patients treated with IMRT are still limited.…”

Neoadjuvant Chemoradiotherapy and Larynx-Preserving Surgery for Cervical Esophageal Cancer

“…The toxicity of dCRT is moderate to severe with severe dysphagia in 5-10% and some life-threatening adverse events [15,16]. The 2-year overall survival rates of patients with CEC treated with dCRT range from 24 to 66% [11,17], comparable to surgery alone [12,18] and remains unsatisfactory.…”