Long-term outcomes and prognostic factors for patients with esophageal cancer following radiotherapy

Chen, Chuangzhen; Chen, Jianzhou; Li, Derui; Lin, Zhongqiu; Zhou, Meifang; Li, Dongsheng; Chen, Zhijian

doi:10.3748/wjg.v19.i10.1639

Cited by 33 publications

(37 citation statements)

References 19 publications

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“…The 10‐year OS rates were 19% and 23%, respectively . An acceptable OS with radiotherapy alone has also been reported in other retrospective studies . All these data suggest a non‐trivial role for radiotherapy alone, especially 3‐DCRT, for esophageal SCC.…”

Section: Discussionsupporting

confidence: 72%

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Three‐dimensional conformal radiation therapy alone for esophageal squamous cell carcinoma: 10‐year survival outcomes

Fan

Wu²,

Wang

et al. 2019

Thoracic Cancer

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Background Concurrent chemoradiation is the standard treatment for locally advanced esophageal squamous cell carcinoma (SCC). We conducted a phase II study to explore the effect of three‐dimensional conformal radiotherapy (3‐DCRT) alone for patients with locally advanced esophageal SCC. This study aimed to analyze the long‐term survival outcomes. Methods Between November 2004 and April 2007, 30 patients with thoracic esophageal SCC underwent late‐course sequential boost 3‐DCRT at Fudan University Shanghai Cancer Center. The planning target volume (PTV1) comprised a 1.2–1.5 cm lateral margin around the gross tumor volume and a 3.0 cm margin, superior and inferior to the gross tumor volume. PTV2 encompassed the gross tumor volume with a margin of 0.5–0.7 cm. The PTV1 dose delivered was 50 Gy, and the PTV2 dose was a boost dose of 16 Gy, resulting in a total dose of 66 Gy. No chemotherapy was administered. Results The median follow‐up time was 30 months for all patients, and 132 months for patients who were alive. The median overall survival was 27 months (95% confidence interval [CI] 18.9–35.0). The 2‐, 5‐, and 10‐year overall survival rates were 56.6%, 33.3%, and 26.6%, respectively. The median progression‐free survival was 14 months (95% CI 7.7–20.2 months), and the 2‐, 5‐, and 10‐year progression‐free survival rates were 33.3%, 30.0%, and 26.6%, respectively. No severe late toxicity was observed in long‐term survivors. Conclusion Late‐course sequential boost 3‐DCRT is safe and feasible with promising long‐term outcomes for esophageal SCC.

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Section: Discussionsupporting

confidence: 72%

“…18 An acceptable OS with radiotherapy alone has also been reported in other retrospective studies. [19][20][21] All these data suggest a non-trivial role for radiotherapy alone, especially 3-DCRT, for esophageal SCC. The target volume of this trial was smaller than that of the RTOG 85-01 and RTOG 94-05 study.…”

Section: Discussionmentioning

confidence: 92%

Three‐dimensional conformal radiation therapy alone for esophageal squamous cell carcinoma: 10‐year survival outcomes

Fan

Wu²,

Wang

et al. 2019

Thoracic Cancer

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“…Nevertheless, in recent years, more and more researches consider TNM stage classification not sufficient to present the prognostic information for the reason that it does not take into account the tumor volume that varies in either T or N classification. Indeed, a few studies have suggested that other clinical factor such as sex, age, BMI, platelet count, tumor length, total dose, concurrent chemotherapy, and weight loss, et al may function as additional prognostic factors (2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…clinical parameters such as the anterior-posterior extent of primary tumor, and the volume of the metastasis lymph node which was currently named tumor burden are correlated with the overall final results (5,7,8). Modern deliver of intensity-modified radiotherapy (IMRT) is based on computed tomography (CT) simulation planning system and target contouring system, which makes it possible to get data of volume of the primary tumor and the metastasis lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

Gross tumor volume is the prognostic factor for squamous cell esophageal cancer patients treated with definitive radiotherapy

Chen¹,

Zhang

Jia³

et al. 2016

J. Thorac. Dis.

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“…Current guidelines recommend de nitive CCRT as a standard component for locally advanced OSCC therapies. However, several studies suggested that certain subgroups of patients failed to bene t from the present de nitive CCRT strategies [6,9]. Therefore, accurately distinguishing the risk subgroups of OSCC patients will help improve the current prognostic system and guide towards more personalized treatment.…”

Section: Discussionmentioning

confidence: 99%

Imaging biomarkers of contrast-enhanced computed tomography predict survival in oesophageal cancer after definitive concurrent chemoradiotherapy

Zeng

Zhai

Chen

et al. 2020

Preprint

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Background: This study aimed to evaluate the predictive potential of contrast-enhanced computed tomography (CT)-based imaging biomarkers (IBMs) for the treatment outcomes of oesophageal squamous cell carcinoma (OSCC) patients after definitive concurrent chemoradiotherapy (CCRT). Methods: Altogether, 154 patients with OSCC who underwent definitive CCRT were included in this retrospective study. All patients were separated randomly to a training cohort (n=99) and the validation cohort (n=55). Pre-treatment contrast-enhanced CT scans were obtained for all patients and used for the extraction of IBMs. An IBM score was constructed by using the least absolute shrinkage and selection operator with Cox regression analysis in the training cohort and tested in the validation cohort. IBM nomograms were built based on IBM scores for individualized survival estimation. Finally, a decision curve analysis was performed to estimate the clinical usefulness of the nomograms. Results: Altogether, 96 IBMs were extracted from each contrast-enhanced CT scan. The IBM score constructed by 11 CT-based IBMs, using LASSO-Cox regression method in training cohort. The multivariate analysis revealed that IBM score was the independent prognostic factor correlated with overall survival (OS) and progression-free survival (PFS). In the training cohort, the C-indices of IBM scores were 0.734 (95%CI, 0.664–0.804) and 0.678 (95%CI, 0.607–0.745) for OS and PFS, respectively. In the validation cohort, C-indices were 0.672 (95%CI, 0.578–0.766) and 0.662 (95%CI, 0.573–0.751) for OS and PFS, respectively. Kaplan-Meier survival analysis showed significantly different between risk subgroups in training and validation cohort. The decision curve showed the clinical usefulness of IBM score. Conclusions: The IBM score based on pre-treatment contrast-enhanced CT could predict the OS and PFS for patients with OSCC after definitive CCRT. Further multicentre studies with larger sample sizes are warranted.

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Long-term outcomes and prognostic factors for patients with esophageal cancer following radiotherapy

Abstract: The overall survival of esophageal carcinoma patients undergoing 3D-CRT was promising. The best predictors for survival were GTV-T and Y diameter.

Cited by 33 publications

References 19 publications

Three‐dimensional conformal radiation therapy alone for esophageal squamous cell carcinoma: 10‐year survival outcomes

Three‐dimensional conformal radiation therapy alone for esophageal squamous cell carcinoma: 10‐year survival outcomes

Gross tumor volume is the prognostic factor for squamous cell esophageal cancer patients treated with definitive radiotherapy

Imaging biomarkers of contrast-enhanced computed tomography predict survival in oesophageal cancer after definitive concurrent chemoradiotherapy

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