Local Ablative Treatment Improves Survival in ESCC Patients With Specific Metastases, 2010–2016: A Population-Based SEER Analysis

Yang, Hui; Wang, Kunlun; Li, Yan; Li, Shenglei; Yuan, Ling; Ge, Hong

doi:10.3389/fonc.2022.783752

Cited by 3 publications

(2 citation statements)

References 29 publications

(34 reference statements)

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“…The current patient received multi-line systemic therapy, including immunotherapy, before the concurrent radiochemotherapy, and did not achieve effective objective remission. In an analysis of the SEER database, the median OS of patients with and without liver-bone metastatic esophageal cancer was six months and nine months, respectively, and the patients were observed to bene t from local treatment [40] . In the current case, SBRT was performed on liver oligometastasis, resulting in reliable local control.…”

Section: Discussionmentioning

confidence: 99%

Multimodal radiotherapy in recurrent refractory metastatic esophageal cancer

Luo

2023

Preprint

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Background To explore the efficacy and toxicity of multimodal radical radiotherapy and systematic therapy in refractory recurrent metastatic esophageal cancer. Patient and Methods A 57-year-old man with locally advanced esophageal squamous cell carcinoma (ESCC) presented with supraclavicular lymph nodes and bone metastases six years after radical resection and adjuvant chemotherapy. After multiline systemic therapy, the tumor progressed with involvement of lymph nodes in the left neck, supraclavicular, subclavian, and axillary regions, as well as the C6 vertebral bone. The patient exhibited Horner’s syndrome on the left side as well as brachial plexus nerve injury with serious pain. Adaptive intensity-modulate radiotherapy (IMRT) combined with high-dose brachy radiotherapy (BRT), and stereotactic radiotherapy (SBRT) was applied to control local foci, together with systemic treatment using target and immunotherapy as maintenance. Results The patient showed complete remission (CR) of symptoms and signs, including the complete disappearance of the left neck metastatic lymph nodes, CR of the left upper-neck metastatic lymph nodes, and satisfactory local control of bone metastases. The progression-free survival (PFS) was more than 20 months, with CR of pulmonary metastases, satisfactory control of hepatic metastases, and PFS for lung and liver foci of over 17 months. No significant adverse events were observed, and the overall survival (OS) was more than 30 months. Conclusions Adaptive IMRT combined with high-dose brachy implantation radiotherapy and maintenance therapy can effectively improve both local control and PFS in patients with refractory recurrent metastatic esophageal cancer.

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Section: Discussionmentioning

confidence: 99%

Multimodal radiotherapy in recurrent refractory metastatic esophageal cancer

Luo

2023

Preprint

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“…With improvements in multimodality therapy, those with oligometastatic disease of various primary sites have been shown to benefit from more aggressive or definitive treatment [4][5][6][7][8]. In esophageal cancer, early reports suggest more aggressive treatment options appear to improve survival for oligometastatic patients [9][10][11][12][13]. There are varying definitions of esophageal oligometastatic disease; for the purposes of this study, it was defined as 5 or less foci of disease [9,14,15].…”

Section: Introductionmentioning

confidence: 99%

Definitive Chemoradiation Associated with Improved Survival Outcomes in Patients with Synchronous Oligometastatic Esophageal Cancer

Matoska

Banerjee

Shreenivas

et al. 2023

Cancers

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Background: The study of oligometastatic esophageal cancer (EC) is relatively new. Preliminary data suggests that more aggressive treatment regimens in select patients may improve survival rates in oligometastatic EC. However, the consensus recommends palliative treatment. We hypothesized that oligometastatic esophageal cancer patients treated with a definitive approach (chemoradiotherapy [CRT]) would have improved overall survival (OS) compared to those treated with a purely palliative intent and historical controls. Methods: Patients diagnosed with synchronous oligometastatic (any histology, ≤5 metastatic foci) esophageal cancer treated in a single academic hospital were retrospectively analyzed and divided into definitive and palliative treatment groups. Definitive CRT was defined as radiation therapy to the primary site with ≥40 Gy and ≥2 cycles of chemotherapy. Results: Of 78 Stage IVB (AJCC 8th ed.) patients, 36 met the pre-specified oligometastatic definition. Of these, 19 received definitive CRT, and 17 received palliative treatment. With a median follow-up of 16.5 months (Range: 2.3–95.0 months), median OS for definitive CRT and palliative groups were 90.2 and 8.1 months (p < 0.01), translating into 5-year OS of 50.5% (95%CI: 32.0–79.8%) vs. 7.5% (95%CI: 1.7–48.9%), respectively. Conclusions: Oligometastatic EC patients treated with definitive CRT benefited from that approach with survival rates (50.5%) that vastly exceeded historical standards of 5% at 5 years for metastatic EC. Oligometastatic EC patients treated with definitive CRT had significantly improved OS compared to those treated with palliative-only intent within our cohort. Notably, definitively treated patients were generally younger and with better performance status versus those palliatively treated. Further prospective evaluation of definitive CRT for oligometastatic EC is warranted.

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