Concurrent chemoradiotherapy with elective lymph node irradiation for esophageal cancer: a systemic review and pooled analysis of the literature

Du, Dexi; Song, Tao; Liang, Xiaodong; Fang, Min; Wu, Shixiu

doi:10.1111/dote.12471

Cited by 16 publications

(14 citation statements)

References 34 publications

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“…A retrospective study of IFI in patients with locally advanced esophageal cancer by Zhang et al11 reported 1-year, 2-year, and 3-year OS rates of 86.3%, 30.0%, and 18.8%, respectively. A meta-analysis of ENI radiotherapy for esophageal cancer reported 1-year, 2-year, 3-year, and 5-year pooled OS rates of 57%, 39%, 40%, and 29%, respectively 19. The results of these studies showed no significant decrease in OS with IFI radiotherapy for esophageal cancer.…”

Section: Discussionmentioning

confidence: 99%

Can involved-field irradiation replace elective nodal irradiation in chemoradiotherapy for esophageal cancer? A systematic review and meta-analysis

Wang¹,

Miao²,

Chen³

et al. 2017

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Chemoradiotherapy is the most common treatment for inoperable esophageal cancer. However, there is no consensus on the delineation of the clinical target volume. Elective nodal irradiation (ENI) is recommended for inoperable esophageal cancer. A few studies have reported a decrease in the incidence of radiation-related toxicity of involved-field irradiation (IFI) for esophageal cancer. A systematic review and pooled analysis were performed to determine whether IFI in definitive chemoradiotherapy was more beneficial than ENI for esophageal cancer. The results showed no significant differences in the overall survival and local control rates between the IFI and ENI arms. Meanwhile, the incidences of esophageal and lung toxicities were significantly decreased in the IFI arm. These results suggest that IFI is a feasible treatment option for locally advanced esophageal cancer, especially to minimize irradiation-related toxicity.

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Section: Discussionmentioning

confidence: 99%

Can involved-field irradiation replace elective nodal irradiation in chemoradiotherapy for esophageal cancer? A systematic review and meta-analysis

Wang¹,

Miao²,

Chen³

et al. 2017

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“…Besides adjuvant chemotherapy, postoperative irradiation has been a major treatment used to decrease the local recurrence rate in patients with ESCC (2,3). According to the nomination of lymph node (LN) stations by the Japanese Society for Esophageal Disease (JSED) (4), it is accepted that 101, 104, 105 and 106 LN stations should be included in the treatment planning of postoperative irradiation in upper thoracic ESCC, as well as 106, 107, 108, 110, 1, 2, 3 and 7 LN stations for middle thoracic ESCC while 107, 108, 110, 112, 1, 2, 3 and 7 LN stations for lower thoracic ESCC, respectively, which were based on the pattern of LNM in ESCC reported by various researchers (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Pattern of lymph node metastasis in thoracic esophageal squamous cell carcinoma with poor differentiation

et al. 2018

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Abstract. The aim of the present study was to explore the patter n of lymph node metastasis (LN M) in poorly-differentiated esophageal squamous cell carcinoma (pdESCC) and the implication of postoperative irradiation. A total of 690 patients with pdESCC were retrospectively investigated. The rates of intro-thoracic and extra-thoracic LNM in pdESCC were investigated and compared to previous research on ESCC en bloc. The comparison of the rates between pdESCC and ESCC were performed using the Cochran-Mantel-Haenszel test. The clinicopathological factors associated with LNM in pdESCC were analyzed by Chi-squared tests, and Fisher's exact test was used to assess the rate difference of extra-thoracic LNM. Logistic-regression analysis was used to explore risk factors associated with lymph node (LN) station. Results demonstrated that the distribution pattern of LNM in pdESCC was significantly different compared with that of ESCC (P<0.05). Univariate and multivariate analysis indicated that risk factors associated with LNM were depth and length (P<0.001 and P<0.001) and multivariate analysis also indicated that the location of the tumor (P= 0.042) was a risk factor associated with LNM in pdESCC. Metastasis in the abdominal cavity was significantly higher than in the neck in the middle and lower thoracic pdESCC (both P<0.01). LN station 102 and 7 for upper thoracic ESCC, 101 and 105 for middle thoracic ESCC, and 100 for lower thoracic ESCC were identified as high-risk stations for metastases in pdESCC compared to ESCC. Several parameters, including location and neck metastasis, were identified as risk factors of metastasis for the above sites, respectively. In conclusion, postoperative therapy should include more LN stations in pdESCC depending on risk factors of tumor metastasis individually.

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“…Esophageal squamous cell carcinoma (ESCC) is the principal pathological subtype of thoracic esophageal cancer reported in Asia in over the previous 30 years (1)(2)(3). Although comprehensive therapeutic strategies, including surgery, radiation therapy and chemotherapy, have been applied, the overall survival (OS) rate of ESCC remains poor (4). It has been widely recognized that lymph node metastasis (LNM) usually occurs in the early stages of disease, and serves an important role in the poor prognosis of patients with ESCC (5).…”

Section: Introductionmentioning

confidence: 99%

Negative lymph node at station 108 is a strong predictor of overall survival in esophageal cancer

et al. 2018

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A negative lymph node (NLN) may represent a stronger predictor for the overall survival (OS) rate of patients with esophageal squamous cell carcinoma (ESCC), when compared with a positive LN (PLN). The present study aimed to investigate which LN station, containing the NLN, was associated with OS rate. A retrospective review was conducted in 216 patients with ESCC and a forward stepwise Cox regression model analysis was used to assess the relationship between clinical parameters and OS rate. Patients were divided into subgroups according to the status of the LN at station 108. Survival analysis was performed using the Kaplan-Meier method. The ratio of albumin-to-globulin (AGR), and of lymphocytes to neutrophil granulocytes (LNR) in the subgroups were also investigated. Overall, 105p (the PLN number at station 105), 108p, 109p and 7p were confirmed to be risk factors for OS rate (all P<0.05). Conversely, 108n (the NLN number at station 108) was identified as a protective factor for OS rate [hazard ratio (HR) 0.457, P=0.001]. Survival analysis demonstrated that patients with an NLN identified at the station 108 had an improved OS rate compared with those with a PLN identified at station 108 (P=0.006). Patients with only an NLN identified at station 108 had the best OS rate among all the sub-groups examined, and the AGR of this group of patients was higher than those of the other groups. The LN status at station 108 may indicate the prognosis of patients with ESCC, and an NLN may reflect the reaction of the immune system to tumor metastasis in these patients.

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Concurrent chemoradiotherapy with elective lymph node irradiation for esophageal cancer: a systemic review and pooled analysis of the literature

Cited by 16 publications

References 34 publications

Can involved-field irradiation replace elective nodal irradiation in chemoradiotherapy for esophageal cancer? A systematic review and meta-analysis

Can involved-field irradiation replace elective nodal irradiation in chemoradiotherapy for esophageal cancer? A systematic review and meta-analysis

Pattern of lymph node metastasis in thoracic esophageal squamous cell carcinoma with poor differentiation

Negative lymph node at station 108 is a strong predictor of overall survival in esophageal cancer

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