Chemoradiotherapy for T4 and/or M1 lymph node esophageal cancer: experience since 2000 at a high-volume center in Japan

Jingu, Keiichi; Umezawa, Rei; Matsushita, Haruo; Sugawara, Toshiyuki; Kubozono, Masaki; Yamamoto, Takaya; Ishikawa, Yojiro; Kozumi, Maiko; Takahashi, Noriyoshi; Katagiri, Yasuo; Kadoya, Noriyuki; Takeda, Ken

doi:10.1007/s10147-015-0896-2

Cited by 25 publications

(19 citation statements)

References 15 publications

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“…As summarized in Tables and , a total of 16 studies examined the outcome of patients with T4 esophageal cancer after dCRT. Two major clinical studies on dCRT for esophageal cancer conducted in Japan, termed JCOG9516 and JCOG0303, were carried out primarily by the Japanese Clinical Oncology Group.…”

Section: Resultsmentioning

confidence: 99%

“…Two major clinical studies on dCRT for esophageal cancer conducted in Japan, termed JCOG9516 and JCOG0303, were carried out primarily by the Japanese Clinical Oncology Group. Of the 16 studies, 13 used CF, and three recent studies reported the concurrent use of triplet chemotherapy (DCF). Font et al used a weekly docetaxel regimen (20 mg/m 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, esophagitis, anorexia, oral mucositis, and esophageal dysphagia were common non‐hematological toxicities (Table ). Fistula formation, including esophagotracheal (bronchial or pulmonary) and esophago‐aortic fistulas, was observed in 9%‐22% of patients with cT4 esophageal cancer during or after dCRT. In the JCOG0303 trial, which included patients with cT4 and/or unresectable regional lymph node metastasis, grades 3‐4 fistula formation occurred in 32 of 140 patients (23%) during or after dCRT.…”

Section: Resultsmentioning

confidence: 99%

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Treatment and clinical outcome of clinical T4 esophageal cancer: A systematic review

Makino

Yamasaki

Miyazaki

et al. 2018

Annals of Gastroent Surgery

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Background Survival of patients with cT4 esophageal cancer is dismal. Although the optimal treatment strategy remains to be established, two treatment options are available for cT4 esophageal cancers: definitive chemoradiation (dCRT) and induction treatment followed by conversion surgery (CS). However, little is known concerning the differences in clinical outcome between patients with T4 esophageal tumors treated with dCRT and those eventually treated with CS. Methods A systematic search of the scientific literature on PubMed/MEDLINE was carried out using the keywords “T4 esophageal cancer,” “invading (involving) adjacent organ,” “definitive chemoradiation,” “induction therapy,” “salvage surgery,” and “conversion surgery,” obtaining 28 reports published up to July 2018. Results/Conclusion We found that CS was superior to dCRT with respect to local disease control and short‐term survival; however, CS was associated with relatively higher perioperative mortality and morbidity. Alternatively, although dCRT might often cause fistula formation, a clinical complete response to dCRT is likely to lead to a better prognosis. Recent advances in chemotherapeutic agents have led to triple induction chemotherapy, with docetaxel, cisplatin, and 5‐fluorouracil (DCF), which has shown promise as an initial induction treatment for cT4 esophageal cancer. Indeed, this regimen could control both local and systemic disease, which enables curative resection without preoperative CRT. Moreover, some appropriate changes in perioperative management and intensive systemic chemotherapy might enhance patient outcome. Randomized controlled trials with a large sample size are needed to establish the standard treatment for cT4 esophageal cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Treatment and clinical outcome of clinical T4 esophageal cancer: A systematic review

Makino

Yamasaki

Miyazaki

et al. 2018

Annals of Gastroent Surgery

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“…Unresectable advanced esophageal cancer is currently treated by using concurrent CCRT consisting of RT at a dose of 60 Gy/fractions and FP therapy (25). However, Jingu et al compared the results for patients irradiated by using >60 Gy with the results for patients irradiated by using ≤60 Gy but found no significant differences in OS or toxicities (14). Ikeda et al studied the use of chemotherapy and palliative 40 Gy for stage IV esophageal cancer, and showed a MST of 308 days (10.3 months), and the 1-year-survival rate was 45.0% at a comparable to 50-60 Gy (15).…”

Section: Discussionmentioning

confidence: 99%

“…Although several studies have investigated prognostic factors for patients with localized esophageal cancer only (13), there is limited data on treatment of patients with distant metastasis. Previously, several studies reported results from irradiation (40 and >60 vs. ≤60 Gy) of patients with distant metastases, but these studies did not determine the optimum dose (14,15). Furthermore, the effectiveness of the combination of multidisciplinary treatment and surgery for these patients was not examined.…”

Section: Original Articlementioning

confidence: 99%

Clinical results of multimodality therapy for esophageal cancer with distant metastasis

et al. 2018

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Background: The purpose of this study is to evaluate outcomes in upfront local response and survival of patients with esophageal cancer and distant metastasis. Methods: This retrospective study included 34 patients (25 males) aged 42-92 years (median, 70 years) with a histological diagnosis of esophageal squamous cell cancer with distant metastasis. Staging was performed according to the UICC's TNM (6th edition) classification of malignant tumor. Results:The median survival time (MST) was 5 months. The 1-year overall survival (OS) was 20.6%.Improved OS was associated with receipt of surgery [hazard ratio (HR), 3.857; 95% CI, 1.142-13.024; P=0.030] on both univariate and multivariate analyses, and the MST was 11 months. The overall objective local response rate was 82%. Ten patients had complete response (CR), 18 had partial response (PR). The overall symptom response was 88% patients. Six had CR, 24 had PR. There was no significant difference in the objective and symptom response between ≤50 and >50 Gy. Concurrent chemoradiotherapy (CCRT) with 50 Gy gave results of objective and symptom responses comparable to those of 60 Gy, which has been reported previously. Conclusions: CCRT with 50 Gy gave results comparable to those of 60 Gy, which has been reported previously, and the toxicity was acceptable. Our findings showed that a multimodality therapy that includes surgery may improve survival in only a select group.

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FDG-PET might not contribute to improving survival in patients with locally advanced inoperable esophageal cancer

et al. 2019

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Chemoradiotherapy for T4 and/or M1 lymph node esophageal cancer: experience since 2000 at a high-volume center in Japan

Abstract: T4 patients without M1 lym showed a relatively good 4-year survival rate of approximately 33 %; however, the results did not show significant improvement after 2000.

Cited by 25 publications

References 15 publications

Treatment and clinical outcome of clinical T4 esophageal cancer: A systematic review

Treatment and clinical outcome of clinical T4 esophageal cancer: A systematic review

Clinical results of multimodality therapy for esophageal cancer with distant metastasis

FDG-PET might not contribute to improving survival in patients with locally advanced inoperable esophageal cancer

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