Factors associated with overall survival and relief of dysphagia in advanced esophageal cancer patients after 125I seed-loaded stent placement: a multicenter retrospective analysis

2019 ◽  
Author(s):  
J Qin ◽  
H-D Zhu ◽  
J-H Guo ◽  
C-F Ni ◽  
P Wu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Retrospective Analysis ◽  
Cancer Patients ◽  
Stent Placement ◽  
125I Seed ◽  
Advanced Esophageal Cancer ◽  
Factors Associated

Outcomes of ERCC1 high locally advanced esophageal cancer patients treated with non-platinum vs platinum based CRT.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 192-192
Author(s):  
Meera Yogarajah ◽  
Chipman Robert Geoffrey Stroud ◽  
Aparna Madhukeshwar Hegde ◽  
Paul R. Walker
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Cancer Patients ◽  
Median Overall Survival ◽  
Locally Advanced ◽  
Advanced Esophageal Cancer ◽  
First Line ◽  
Line Chemotherapy ◽  
Locally Advanced Esophageal Cancer ◽  
Platinum Doublet

192 Background: ERCC1 is a DNA excision repair enzyme which repairs the DNA adduct damage caused by platinum and hence high levels of ERCC1 has been associated with platinum resistance. Thus utility of platinum as a first line chemotherapy in esophageal cancers with high ERCC1 levels is controversial. SWOG S0356 trial noted a significantly low 2 year overall survival of 37% for platinum based CRT in ERCC1 high esophageal carcinomas, yet no studies have identified the alternative first line chemotherapy. Our Program utilized combined irinotecan 65mg/m2 on D1 and D8 and nab-paclitaxel 100mg/m2with concurrent radiation therapy of 50.4Gy for ERCC1 high esophageal cancers at the treating physician’s discretion. We compared the differences in survival with non-platinum versus platinum CRT. Methods: Retrospective analysis from 2011 to 2016 identified 25 locally advanced esophageal cancer patients in whom ERCC1 levels were checked. Out of this 25 patients 23 had high ERCC1 levels and 2 had low ERCC1 levels. Patients with low ERCC1 were excluded. Patients with high ERCC1 levels received either non-platinum or platinum CRT as neo-adjuvant, adjuvant or definitive chemotherapy. Results: Patient characteristics: Male 69.5%, female 30.5%, squamous 43.4%, adenocarcinoma 52.1%, other 4.5%, operable 39%, non-operable 61%. Non-platinum therapy was utilized for 69.5% and platinum based therapy for 30.5% of the patients. Kaplan-Meier analysis for survival showed clear separation of the curves around 2 years. Median overall survival of non-platinum doublet was not reached during a median follow up of 22 months. Overall survival at 2 years was 57%. The median overall survival for the platinum doublet was 22 months and the 2 year overall survival was 42%. (p = 0.22). Hazard ratio (HR) 0.48(95% CI 0.14-1.58 p = 0.23) .This statistical non significance was due to small sample size. Conclusions: Abraxane and irinotecan showed improved overall survival in the ERCC1 high group when compared with platinum based therapy demonstrated both in our population and the SWOG 0356 trial. [Table: see text]

scholarly journals Assesment of placement of the esophageal self-expandable metallic stent in esophageal cancer in patients with or without citorreduction therapy

2007 ◽  
Vol 20 (3) ◽  
pp. 154-160
Author(s):  
Gilson Kamiyama ◽  
Paulo Sakai ◽  
Eduardo Guimarães H. de Moura ◽  
Shinichi Ishioka ◽  
Ivan Cecconello ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Time ◽  
Stent Placement ◽  
Gastrointestinal Endoscopy ◽  
Thoracic Esophagus ◽  
Metallic Stent ◽  
Advanced Esophageal Cancer ◽  
Expandable Metallic Stent ◽  
Stent Treatment ◽  
Time Average

BACKGROUND: Placement of self-expanding metallic esophageal stent in patients with advanced esophageal cancer offers excellent palliation of dysphagia and tracheo-esophageal fistulas. However, the safety of stent in patients undergoing radio and/or chemotherapy is controversial, in terms of the greater risk of complications in cases where these two treatments are used in conjunction. AIM: To assess the use of stent in patients with advanced cancer of the mid-thoracic esophagus, by comparing patients undergoing cytoreductive therapy with patients who have not undergone this treatment, in relation to improvement in the dysphagia, rate of complications, period of effectiveness and survival time. METHODS: Fifty seven patients were evaluated retrospectively (16 women and 41 men, with an average age 62 years) with advanced squamous cell carcinoma of the mid-thoracic esophagus who underwent placement of the Ultraflex™ self-expandable metallic coated stent, at the Gastrointestinal Endoscopy Unit of São Paulo University Medical School between October 1988 and October 2004. Out of the 57 patients, 24 patients received adjuvant cytoreductive therapy, and 33 patients were only treated with the stent placement. RESULTS: After stent placement, there was improvement in dysphagia in both groups; there were no differences in the rate of complications, such as migration, pain, fistula, obstruction and compression of the airways; the period of effectiveness was significantly higher in the group submitted to cytoreductive therapy (average 123 days compared to 63 days), as was the survival time (average of 210 days, compared with 120 days). CONCLUSIONS: Improvement in dysphagia was statistically significant in both groups, irrespective of whether the patient had undergone adjuvant cytoreductive therapy; there were no differences in the rate of complications between the two groups and both the period of effectiveness of the stent treatment and the survival time were higher in the group with adjuvant cytoreductive therapy.

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