Esophagectomy for locally advanced esophageal cancer, followed by chemoradiotherapy and adjuvant chemotherapy

Liu, Hung Chang; Hung, Shih‐Kai; Huang, Charn Jer; Chen, Chung Chu; Chen, Ming Jen; Chang, Chun Chao; Tai, Ching Tai; Tzen, Chin Yuan; Li, Lu; Chen, Yu-Jen

doi:10.3748/wjg.v11.i34.5367

Cited by 31 publications

(22 citation statements)

References 25 publications

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“…Curative surgery of the esophagus is usually performed for lesions of the gastroesophageal junction and the middle or lower third of the thoracic esophagus. Radiationtherapy and chemotherapy may be added [11][12][13][14][15]. Surgery for the squamous cell carcinoma of the cervical esophagus is very extensive and cause major functional impairments and high morbidity and mortality rates.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and outcome of patients with stage III esophageal carcinoma: a single-center experience from Turkey

et al. 2007

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Esophageal carcinoma is an extremely deadly disease, and prognosis is poor. We retrospectively evaluated stage III esophageal carcinoma patients in our center. Median age of the patients was 52. Men to women ratio were 3/1. Epidermoid carcinoma was the major histology. Incidence of esophageal carcinoma was higher in the distal and middle third of the esophagus. In 19 patients tumor size was more than 5 cm. In total of 17 of the patients were operated. About 58 patients were irradiated. About 45 of the patients were irradiated with curative intent, 31 of them were primarily irradiated and 14 of them were irradiated postoperatively. Only 13 of the patients received concurrent chemoradiotherapy. Overall 1, 2, 3, and 4 year survival rates were 38.9%, 11.1%, 5.6%, and %1.9, respectively and median survival was 12 months. Median survival for tumors located in cervical esophageal, middle esophagus, and distal esophagus were 23, 8, and 14 months, respectively. One, 2, 3, 4 year survival rates of operated patients were 58.8%, 29.4%, 17.6%, 5.9%, respectively and median survival was 23 months. For inoperable patients 1 and 2 year survival rates were 29.7% and 2.7% and median survival was 8 months. Differences between operable and inoperable patients were statistically significant (P: 0.0003). One, 2, 3, 4 years survival results of patients treated with surgery and postoperative radiotherapy was 62.5%, 25%, 12.5%, 12.5% and median survival was 21 months, 1, 2, 3, 4 years survival results of patients treated with surgery and concurrent chemoradiotherapy was 55.6%, 33.3%, 22.2%, and 0% and median survival was 27 months. There was no statistically significant difference between groups (P: 0.5390). During the therapy, disphagia was the major side effect observed in seven patients. Fatigue, pain, and mild weight loss were the other side effects. Three patients could not tolerate the treatment and left the therapy. We demonstrated that stage III esophageal carcinoma is an extremely deadly disease, and in spite of major advances in cancer treatment, prognosis is still poor.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics and outcome of patients with stage III esophageal carcinoma: a single-center experience from Turkey

et al. 2007

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“…We believe that hematogenous metastasis was the main cause of failure in the S + R group. As 2 recent studies have suggested that postoperative chemotherapy can decrease lymphoma metastasis and increase progression-free survival [20,21], and several retrospective analyses have demonstrated that postoperative concurrent chemoradiotherapy enhanced OS compared with surgery alone or postoperative chemotherapy [22,23,24], we intend to optimize postoperative IMRT and chemotherapy together in future studies to decrease hematogenous metastasis. Our next study will focus on how to decrease hematogenous metastasis.…”

Section: Commentmentioning

confidence: 99%

Postoperative Intensity-Modulated Radiotherapy Improved Survival in Lymph Node-Positive or Stage III Thoracic Esophageal Squamous Cell Carcinoma

et al. 2015

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Background: The aim of this study was to retrospectively analyze the effect of postoperative intensity-modulated radiotherapy (IMRT) on recurrence and survival in lymph node-positive or stage III thoracic esophageal squamous cell carcinoma (TESCC) patients, and evaluate its role in TESCC therapy. Methods: We enrolled 538 patients who underwent radical resection with (S + R) or without (S) postoperative IMRT. The median total postoperative IMRT dose was 60 Gy. The Kaplan-Meier method, log-rank test, and chi-square test were used for survival rate calculation, univariate analysis, and sites of failure analysis, respectively. Results: The 5-year overall survival (OS) and disease-free survival rates were 32.7 and 27.3%, respectively. The 5-year OS rates of lymph node-positive S and S + R patients were 28.4 and 38.8%, respectively (p < 0.001). The 5-year OS rates of stage III S and S + R patients were 24.0 and 38.0%, respectively (p = 0.001). Postoperative IMRT resulted in significantly decreased intrathoracic and supraclavicular recurrence, and obviously delayed median local recurrence and systemic metastases. Systemic metastases increased following postoperative IMRT. Conclusion: Postoperative IMRT reduces local recurrence and improves survival in lymph node-positive or stage III TESCC patients, providing a rationale for selection criteria for postoperative IMRT in TESCC.

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“…Patients with unresectable or medically inoperable disease are usually treated with concurrent radiotherapy and chemotherapy for preoperative or definitive treatment. [2][3][4] Although various chemotherapy regimens are available, esophageal cancer carries a very poor prognosis, with a mean survival time of less than 8.1 months. 5 Currently, neoadjuvant treatment (such as capecitabine and cisplatin with concurrent radiotherapy (RT) followed by esophagectomy) is considered the effective treatment for esophageal cancer, 6,7 leading to complete pathologic response at the time of surgical resection and improved local tumor control and eradication of micrometastases.…”

Section: Introductionmentioning

confidence: 99%

External beam radiotherapy synergizes 188Re-liposome against human esophageal cancer xenograft and modulates 188Re-liposome pharmacokinetics

Chang¹,

Liu²,

Wen³

et al. 2015

IJN

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External beam radiotherapy (EBRT) treats gross tumors and local microscopic diseases. Radionuclide therapy by radioisotopes can eradicate tumors systemically. Rhenium 188 ( 188 Re)-liposome, a nanoparticle undergoing clinical trials, emits gamma rays for imaging validation and beta rays for therapy, with biodistribution profiles preferential to tumors. We designed a combinatory treatment and examined its effects on human esophageal cancer xenografts, a malignancy with potential treatment resistance and poor prognosis. Human esophageal cancer cell lines BE-3 (adenocarcinoma) and CE81T/VGH (squamous cell carcinoma) were implanted and compared. The radiochemical purity of 188 Re-liposome exceeded 95%. Molecular imaging by NanoSPECT/CT showed that BE-3, but not CE81T/VGH, xenografts could uptake the 188 Re-liposome. The combination of EBRT and 188 Re-liposome inhibited tumor regrowth greater than each treatment alone, as the tumor growth inhibition rate was 30% with EBRT, 25% with 188 Re-liposome, and 53% with the combination treatment at 21 days postinjection. Combinatory treatment had no additive adverse effects and significant biological toxicities on white blood cell counts, body weight, or liver and renal functions. EBRT significantly enhanced the excretion of 188 Re-liposome into feces and urine. In conclusion, the combination of EBRT with 188 Re-liposome might be a potential treatment modality for esophageal cancer.

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Esophagectomy for locally advanced esophageal cancer, followed by chemoradiotherapy and adjuvant chemotherapy

Abstract: For locally advanced esophageal cancer, the combination of esophagectomy, post-operative CCRT with weekly cisplatin and systemic adjuvant chemotherapy is well tolerated and effective. A large-scale, prospective randomized trial of this regimen is in progress.

Cited by 31 publications

References 25 publications

Clinical characteristics and outcome of patients with stage III esophageal carcinoma: a single-center experience from Turkey

Clinical characteristics and outcome of patients with stage III esophageal carcinoma: a single-center experience from Turkey

Postoperative Intensity-Modulated Radiotherapy Improved Survival in Lymph Node-Positive or Stage III Thoracic Esophageal Squamous Cell Carcinoma

External beam radiotherapy synergizes 188Re-liposome against human esophageal cancer xenograft and modulates 188Re-liposome pharmacokinetics

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Esophagectomy for locally advanced esophageal cancer, followed by chemoradiotherapy and adjuvant chemotherapy

Abstract: For locally advanced esophageal cancer, the combination of esophagectomy, post-operative CCRT with weekly cisplatin and systemic adjuvant chemotherapy is well tolerated and effective. A large-scale, prospective randomized trial of this regimen is in progress.

Cited by 31 publications

References 25 publications

Clinical characteristics and outcome of patients with stage III esophageal carcinoma: a single-center experience from Turkey

Clinical characteristics and outcome of patients with stage III esophageal carcinoma: a single-center experience from Turkey

Postoperative Intensity-Modulated Radiotherapy Improved Survival in Lymph Node-Positive or Stage III Thoracic Esophageal Squamous Cell Carcinoma

External beam radiotherapy synergizes 188Re-liposome against human esophageal cancer&nbsp;xenograft and modulates 188Re-liposome pharmacokinetics

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External beam radiotherapy synergizes 188Re-liposome against human esophageal cancer xenograft and modulates 188Re-liposome pharmacokinetics