Neoadjuvant versus adjuvant chemoradiation for stage II–III esophageal squamous cell carcinoma: a single institution experience*

2017 ◽  
Vol 30 (7) ◽  
pp. 1-7 ◽  
Author(s):  
Y. Chen ◽  
D. Hao ◽  
X. Wu ◽  
W. Xing ◽  
Y. Yang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Stage Ii ◽  
Single Institution ◽  
Adjuvant Chemoradiation

Feasibility study of neoadjuvant chemoradiotherapy with cisplatin plus 5-fluorouracil and elective nodal irradiation for stage II/III esophageal squamous cell carcinoma.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 130-130 ◽  
Author(s):  
Takashi Kojima ◽  
Jun Hashimoto ◽  
Ken Kato ◽  
Yoshinori Ito ◽  
Hiroyasu Igaki ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Feasibility Study ◽  
Squamous Cell ◽  
Neoadjuvant Chemoradiotherapy ◽  
Stage Ii ◽  
Elective Nodal Irradiation

130 Background: Based on the JCOG 9907 trial results, neoadjuvant chemotherapy with cisplatin (CDDP) plus 5-fluorouracil (5-FU) is considered a standard treatment for stage II/III esophageal squamous cell carcinoma (ESCC) in Japan. However, patient survival remains unsatisfactory. We conducted a feasibility study of neoadjuvant chemoradiotherapy (NeoCRT) with CDDP plus 5-FU and elective nodal irradiation for stage II/III ESCC. Methods: Eligibility criteria included clinical stage II/III (UICC 6th, non-T4) ESCC, PS 0-1, and age 20–75 years. Chemotherapy consisted of 2 courses of 5-FU infusion (1000 mg/m2, days 1–4) and a 2-h CDDP infusion (75 mg/m2, day 1), with a 4-week interval. Radiotherapy was concurrently administered to a total 41.4 Gy in 23 fractions for primary tumor, metastatic lymph nodes and regional lymph nodes. After completion of CRT, transthoracic esophagectomy with extensive lymphadenectomy (>D2) was performed. The primary endpoint was the completion rate of NeoCRT and R0 resection. Results: From July 2010 to June 2011, 33 patients were enrolled, including 2 ineligibles. In 31 eligible patients, the median age was 63 years (range, 40–73); male/female: 28/3; PS0/1: 19/12; cStage IIA/IIB/III: 2/10/19. During CRT, the most common grade 3 or 4 toxicities were leukopenia (65%), neutropenia (65%), anemia (13%), thrombocytopenia (13%), febrile neutropenia (13%), anorexia (16%), esophagitis (16%), and hyponatremia (16%). In total, 31 patients (100%) underwent CRT and 25 (81%) underwent surgery; 1 patient (3%) did not undergo surgery due to disease progression, and the other 5 patients (16%) are scheduled for surgery. Among patients who underwent surgery, there was 1 treatment-related death, and the incidence of operative morbidity was similar to that in previous studies. According to RECIST, the overall response rate was 63% after CRT completion. Pathological complete response was achieved in 11 patients (44%) who underwent esophagectomy. Conclusions: NeoCRT was well tolerated and appears to be highly promising. The randomized controlled trial compared with neoadjuvant chemotherapy is needed and will be started.

Neoadjuvant or adjuvant chemoradiation therapy for stage II-III esophageal squamous cell carcinoma.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 202-202
Author(s):  
Yongshun Chen ◽  
Daxuan Hao ◽  
Xiaoyuan Wu ◽  
Yuanyuan Yang ◽  
Chunyu He ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Postoperative Complications ◽  
Adjuvant Therapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Median Survival ◽  
Neoadjuvant Chemoradiation ◽  
Stage Ii ◽  
Survival Times ◽  
Adjuvant Chemoradiation

202 Background: Esophageal cancer is the eighth most common cancer worldwide, and especially in China is the fourth most common cause of death. Clinical trials have explored the value of neoadjuvant or adjuvant chemoradiation in potentially resectable esophageal squamous cell carcinoma (ESCC); however, these studies have produced conflicting results. This retrospective study was performed to investigate whether patients with resectable stage II/III ESCC should receive neoadjuvant or adjuvant therapy in addition to surgery. Methods: A review of stage II/III ESCC patients who underwent esophagectomy and either neoadjuvant or adjuvant chemoradiation was performed. Patients who underwent neoadjuvant therapy were treated with one cycle of chemotherapy consisted of cisplatin and fluorouracil concurrently with radiotherapy (40Gy/20f), adjuvant therapy consisted of two cycles of chemotherapy concurrently with radiotherapy (46-50Gy/23-25f, 5 days/week). Results: A total of 122 patients met inclusion criteria, of which 49 underwent neoadjuvant chemoradiation and 73 underwent adjuvant chemoradiation. Median follow up was 36.5 months. The median survival times and 3, 5-year OS rates for the neoadjuvant and adjuvant groups were 39.3 vs 31.5 months, and 53.0%, 45.7% vs 42.9%, 29.7% respectively (p = 0.091). For the patients with stage III ESCC, the median survival times and 5-year OS rates for the neoadjuvant and adjuvant group were 39.3 vs 21.2 months, and 43.4% vs 15.4% respectively (p = 0.005). Among lymph node-positive patients, the median survival times and 5-year OS rates for the neoadjuvant and adjuvant groups were 55.6 vs 23.7 months, and 43.0% vs 25.7% respectively (p = 0.085). The incidence of postoperative complications was 26.5% (13/49) in the neoadjuvant group and 20.5% (15/73) in the adjuvant group (p = 0.212). Conclusions: Neoadjuvant chemoradiation does not increase postoperative complications, and is associated with better OS when compared to adjuvant chemoradiation. OS in stage III patients is significantly improved with the use of neoadjuvant chemoradiation.

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