Long-term results of chemoradiotherapy for stage II-III thoracic esophageal cancer in a single institution after 2000 -with a focus on comparison of three protocols-

Rei Umezawa, Keiichi Jingu, Haruo Matsushita, Toshiyuki Sugawara, Masaki Kubozono, Takaya Yamamoto, Yojiro Ishikawa, Maiko Kozumi, Noriyoshi Takahashi, Yu Katagiri, Noriyuki Kadoya, Ken Takeda, Hisanori Ariga, Kenji Nemoto, Shogo Yamada

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7 Citations (Scopus)

Abstract

Background: To evaluate the long-term results of chemoradiotherapy (CRT) for stage II-III thoracic esophageal cancer mainly by comparing results of three protocols retrospectively. Methods: Between 2000 and 2012, 298 patients with stage II-III thoracic esophageal cancer underwent CRT. Patients in Group A received two cycles of cisplatin (CDDP) at 70 mg/m2 (day 1 and 29) and 5-fluorouracil (5-FU) at 700 mg/m2/24 h (day 1-4 and 29-32) with radiotherapy (RT) of 60 Gy without a break. Patients in Group B received two cycles of CDDP at 40 mg/m2 (day 1, 8, 36 and 43) and 5-FU at 400 mg/m2/24 h (day 1-5, 8-12, 36-40 and 43-47) with RT of 60 Gy with a 2-week break. Patients in Group C received two cycles of nedaplatin at 70 mg/m2 (day 1 and 29) and 5-FU at 500 mg/m2/24 h (day 1-4 and 29-32) with RT of 60-70 Gy without a break. Differences in prognostic factors between the groups were analyzed by univariate and multivariate analyses. Results: The 5-year overall survival rates for patients in Group A, Group B and Group C were 52.4, 45.2 and 37.2 %, respectively. The 5-year overall survival rates for patients in Stage II, Stage III (non-T4) and Stage III (T4) were 64.0, 40.1 and 22.5 %, respectively. The 5-year overall survival rates for patients who received 1 cycle and 2 cycles of concomitant chemotherapy were 27.9 and 46.0 %, respectively. In univariate analysis, stage, performance status and number of concomitant chemotherapy cycles were significant prognostic factors (p < 0.001, p = 0.008 and p < 0.001, respectively). In multivariate analysis, stage, protocol and number of concomitant chemotherapy cycles were significant factors (p < 0.001, p = 0.043 and p < 0.001, respectively). Conclusions: The protocol used in Group A may be an effective protocol of CRT for esophageal cancer. It may be important to complete the scheduled concomitant chemotherapy with the appropriate intensity of CRT.

Original languageEnglish
Article number813
JournalBMC Cancer
Volume15
Issue number1
DOIs
Publication statusPublished - 2015 Oct 27

Keywords

  • Chemoradiotherapy
  • Esophageal cancer
  • Squamous cell carcinoma
  • Stage II-III

ASJC Scopus subject areas

  • Genetics
  • Oncology
  • Cancer Research

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