AI Article Synopsis
- The study evaluated the effectiveness and toxicity of selective lymph node conventional fraction radiotherapy (SLN CFRT) combined with chemotherapy in 67 patients with advanced esophageal squamous cell carcinoma (ESCC).
- The treatment involved a total dose of 60 Gy of radiotherapy over 6 weeks, along with two cycles of cisplatin and S-1 chemotherapy, resulting in an objective response rate (ORR) of 82.5%.
- Although the treatment showed promising response rates, patients experienced significant side effects, including severe leukopenia and other toxicities, with some resulting in death from complications.
Article Abstract
Background: The efficacy, toxicity, and patterns of failure of esophageal squamous cell carcinoma (ESCC) treated with selective lymph node (SLN) conventional fraction radiotherapy (CFRT) and S-1 plus cisplatin (CDDP) were evaluated.
Patients And Methods: 67 Patients with clinical stage II-IVa ESCC were enrolled. The total dose of SLN CFRT was 60 Gy in 30 fractions over 6 weeks. The first course of radiation covered the primary and metastatic regional tumors and high-risk lymph nodal regions, given at 2 Gy/fraction for a dose of 40 Gy. In the second course, CFRT was delivered to the boost volume for an additional 20 Gy in 10 days, using 2 Gy/fraction. Two cycles of chemotherapy were given at the beginning of radiotherapy. CDDP at 25 mg/m/day was given on days 1-3 and days 22-24, and S-1 at 80 mg/m/day on days 1-14 and days 22-35. Patients achieving objective response after concurrent chemoradiotherapy underwent two additional cycles of chemotherapy.
Results: The objective response rate (ORR) was 82.5%. Grade 3 or 4 toxicities included leukopenia (23.8%), neutropenia (14.3%), thrombocytopenia (14.3%), hemoglobin (4.8%), gastrointestinal (12.7%), skin (1.6%), and esophagus fistula (1.6%). One patient died of severe pneumonia, and two died of late toxicity because of esophagus fistula. With median follow-up of 32 months, the overall survival (OS) and progression-free survival (PFS) at 1 year and 2 years were 81.0% and 73.0%, and 63.5% and 49.2%, respectively.
Conclusions: SLN RT concurrent with S-1 plus CDDP may represent a better strategy for treatment of ESCC patients.
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| http://dx.doi.org/10.1245/s10434-019-07264-4 | DOI Listing |
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