Radiotherapy With or Without Concurrent Chemotherapy for Lymph Node Recurrence After Radical Surgery of Thoracic Esophageal Squamous Cell Carcinoma

Lu, Jicun; Kong, C. S.; Tao, Hua

doi:10.1016/j.ijrobp.2009.08.065

Cited by 23 publications

(26 citation statements)

References 20 publications

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“…Some studies on the effectiveness of radiotherapy with or without chemotherapy for treatment of postoperative recurrent ESCC reported 2-year survival rates of only 15-31% with short-term observation. Lu et al reported that the OS of all 73 recurrent ESCC patients was 46.7% and 4.7% at 1 and 3 years respectively, and patients receiving CCRT had better OS than those receiving RT alone with 1-year OS 62.5% in CCRT group vs. 33.8% in RT alone group, 3-year OS 10.5% in CCRT group vs. 0% in RT alone group [12]. A recent phase II study on radiotherapy combined with nedaplatin and 5-Fu for postoperative loco-regional recurrent ESCC showed improved 5-year OS of 27.0%.…”

Section: Discussionmentioning

confidence: 99%

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Three-dimensional conformal radiotherapy with concurrent chemotherapy for postoperative recurrence of esophageal squamous cell carcinoma: clinical efficacy and failure pattern

et al. 2013

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BackgroundTo assess the therapeutic outcome and failure pattern of three-dimensional conformal radiotherapy (3D-CRT)-based concurrent chemoradiotherapy (CCRT) for recurrence of esophageal squamous cell carcinoma (SCC) after radical surgery.MethodsTreatment outcome and failure pattern were retrospectively evaluated in 83 patients with localized cervical and thoracic recurrences after radical surgery for thoracic esophageal SCC. All patients were treated with 3DCRT-based CCRT (median radiation dose 60 Gy), in which 39 received concurrent cisplatin plus 5-fluorouracil (PF), and 44 received concurrent docetaxel plus cisplatin (TP). Treatment response was evaluated at 1–3 months after CCRT.ResultsWith a median follow-up of 34 months (range, 2–116 months), the 3-year overall survival (OS) of all the patients was 51.8% and the median OS time was 43.0 months. The overall tumor response rate was 75.9% (63/83), with a complete remission (CR) rate of 44.6% (37/83). In univariate analysis, tumor response after CCRT (p = 0.000), recurrence site (p = 0.028) and concurrent chemotherapy (p = 0.090) showed a trend favoring better OS. Multivariate analysis revealed that tumor response after CCRT (p = 0.000) and concurrent chemotherapy (p = 0.010) were independent predictors of OS. Forty-seven patients had progressive diseases after CCRT, 27 had local failure (27/47, 57.4%), 18 had distant metastasis (18/47, 38.3%) and 2 had both local and distant failures (2/47, 4.3%).Conclusions3DCRT-based CCRT is effective in postoperatively recurrent esophageal SCC. Patients that obtained complete remission after CCRT appeared to achieve long-term OS and might benefit from concurrent TP regimen. Local and distant failures remained high and prospective studies are needed to validate these factors.

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Section: Discussionmentioning

confidence: 99%

“…Since these patients hadn’t received radiotherapy (RT) or chemotherapy before, RT combined with concurrent chemotherapy might have a beneficial symptomatic effect and a possibility to obtain long-term survival [12-16]. Thus, the factors affecting this survival after postoperative recurrence in ESCC patients need to be fully explored.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional conformal radiotherapy with concurrent chemotherapy for postoperative recurrence of esophageal squamous cell carcinoma: clinical efficacy and failure pattern

et al. 2013

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“…Patients were placed in a supine-position-vacuum bag with crossed fingers and hands at head top; the supraclavicular areas and superior mediastinum were irradiated in patients with upper thoracic esophageal cancer; the supraclavicular areas and superior and inferior mediastinum were irradiated in patients with middle thoracic esophageal cancer; and the superior and inferior mediastinum were irradiated in patients with low thoracic esophageal cancer. 6,16 The epigastrium was also selectively irradiated in some patients. The planning target volume was generated using a uniform 0.5 cm expansion beyond the borders of the clinical target volume.…”

Section: Prophylactic Therapy Regimenmentioning

confidence: 99%

Effect of different prophylactic therapies on the recurrence pattern of esophageal squamous cell carcinoma after radical surgery

Chen

et al. 2020

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Background To compared the patterns of lymph node recurrence after different prophylactic therapies to identify specific and effective target areas for prophylactic radiotherapy. Methods This retrospective study enrolled patients with recurrence from August 2011 to November 2015, who underwent different prophylactic therapies for esophageal squamous cell carcinoma after radical surgery previously. The patients were divided into unprotected, radiotherapy, chemotherapy, and radiochemotherapy groups. The recurrence patterns between these groups were compared. Results A total of 186 patients who met the above criteria were enrolled. The recurrence ratios of regional lymph nodes were 84.2%, 31.3%, 84.0%, and 48.0% in the unprotected, radiotherapy, chemotherapy, and radiochemotherapy groups, respectively. The recurrence ratio of regional lymph nodes in patients who received radiotherapy was significantly decreased ( P =0.009). The recurrence ratio of superior mediastinal lymph node was significantly lower than those of the chemotherapy and unprotected groups ( P =0.000). The recurrence ratios of the radiotherapy group with and without epigastrium coverage were 4/16 and 4/25, respectively, indicating no statistical difference with those of other groups ( P =0.259). The recurrence ratios with and without the coverage of anastomotic sites were 2/19 and 3/22, respectively, revealing no statistical difference with those of other groups ( P =0.712). Conclusion Prophylactic radiotherapy can significantly reduce the recurrence of regional lymph nodes, especially lymph node recurrence on the superior mediastinum.

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“…On the other hand, radiation therapy (RT), chemoradiation therapy (CRT), or lymphadenectomy have been used in treating LR. These treatments have had a beneficial symptomatic effect for a significant proportion of those patients and have shown that it is possible to obtain a long‐term survival effect in some patients …”

Section: Introductionmentioning

confidence: 99%

“…These treatments have had a beneficial symptomatic effect for a significant proportion of those patients and have shown that it is possible to obtain a long-term survival effect in some patients. [8][9][10][11][12][13][14][15][16][17][18][19][20] The purpose of this retrospective study was to assess the efficacy of salvage RT or CRT for LR after surgery for esophageal cancer.…”

Section: Introductionmentioning

confidence: 99%

Salvage radiation therapy and chemoradiation therapy for postoperative locoregional recurrence of esophageal cancer

et al. 2013

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The purpose of this retrospective study was to assess the efficacy of salvage radiation therapy (RT) or chemoradiation therapy (CRT) for locoregional recurrence (LR) of esophageal cancer after curative surgery. Forty-two patients who received salvage RT or CRT for LR of esophageal cancer after curative surgery between November 2000 and May 2012 were reviewed. The intended RT regimen was 60 Gy in 30 fractions combined with concurrent platinum-based chemotherapy. Median follow-up periods were 17.9 months for all evaluable patients and 28.2 months for patients still alive (19 patients) at analysis time. The 1-, 2-, and 3-year survival rates were 81.2 ± 6.4%, 51.3 ± 8.6%, and 41.1 ± 8.7%, respectively, with a median survival time of 24.3 ± 4.1 months. Out of 41 evaluable patients, 16 patients (39%) were alive beyond 2 years from salvage therapy. However, univariate analyses for overall survival showed no significant prognostic factor. Grade 3 or higher leukocytopenia was observed in 46% of the patients. Salvage RT or CRT for LR after surgery for esophageal cancer was safe and effective. These therapies may offer long-term survival to some patients. RT or CRT should be considered for LR.

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Radiotherapy With or Without Concurrent Chemotherapy for Lymph Node Recurrence After Radical Surgery of Thoracic Esophageal Squamous Cell Carcinoma

Cited by 23 publications

References 20 publications

Three-dimensional conformal radiotherapy with concurrent chemotherapy for postoperative recurrence of esophageal squamous cell carcinoma: clinical efficacy and failure pattern

Three-dimensional conformal radiotherapy with concurrent chemotherapy for postoperative recurrence of esophageal squamous cell carcinoma: clinical efficacy and failure pattern

Effect of different prophylactic therapies on the recurrence pattern of esophageal squamous cell carcinoma after radical surgery

Salvage radiation therapy and chemoradiation therapy for postoperative locoregional recurrence of esophageal cancer

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