Combined chemoradiotherapy vs. radiotherapy alone for early stage squamous cell carcinoma of the esophagus: a study of the eastern cooperative oncology group

Smith, Thomas J.; Ryan, Louise; Douglass, Harold O.; Haller, Daniel G.; Dayal, Yogeshwar; Kirkwood, John M.; Tormey, Douglas C.; Schutt, Alan J.; Hinson, J.; Sischy, Ben

doi:10.1016/s0360-3016(98)00232-6

Cited by 231 publications

(31 citation statements)

References 17 publications

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“…They also found that most patients failed secondary to having persistent localized disease which appeared to be controlled better with concurrent therapy. Other studies also have confirmed similar findings in outcomes survival, favoring chemoradiation compared to radiation alone 45, 46 .…”

Section: Radiation Therapysupporting

confidence: 63%

Update: Modern Approaches to the Treatment of Localized Esophageal Cancer

et al. 2011

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Esophageal cancer treatment continues to be a topic of wide debate. Based on improvements in chemotherapy drugs, surgical techniques, and radiotherapy advances, esophageal cancer treatment approaches are becoming more specific to the stage of the tumor and the overall performance status of the patient. While surgery continues to be the standard treatment option for localized disease, the current direction favors multimodality treatment including both radiation and chemotherapy with surgery. In the next few years, we will continue to see improvements in radiation techniques and proton treatment, with more minimally invasive surgical approaches minimizing postoperative side effects, and the discovery of molecular biomarkers to help deliver more specifically targeted medication to treat esophageal cancers.

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Section: Radiation Therapysupporting

confidence: 63%

Update: Modern Approaches to the Treatment of Localized Esophageal Cancer

et al. 2011

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“…Radiotherapy is the standard nonsurgical therapy for esophageal cancer patients 25, 26. Acquired radioresistance during radiotherapy for ESCC patients is a serious concern 4, and its regulating molecular networks remains elusive.…”

Section: Discussionmentioning

confidence: 99%

mRNA and methylation profiling of radioresistant esophageal cancer cells: the involvement of Sall2 in acquired aggressive phenotypes

Luo¹,

Wang²,

Tang³

et al. 2017

J. Cancer

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Esophageal squamous cell carcinoma (ESCC) is one of the deadliest malignancies worldwide. Radiotherapy plays a critical role in the curative management of inoperable ESCC patients. However, radioresistance restricts the efficacy of radiotherapy for ESCC patients. The molecules involved in radioresistance remain largely unknown, and new approaches to sensitize cells to irradiation are in demand. Technical advances in analysis of mRNA and methylation have enabled the exploration of the etiology of diseases and have the potential to broaden our understanding of the molecular pathways of ESCC radioresistance. In this study, we constructed radioresistant TE-1 and Eca-109 cell lines (TE-1/R and Eca-109/R, respectively). The radioresistant cells showed an increased migration ability but reduced apoptosis and cisplatin sensitivity compared with their parent cells. mRNA and methylation profiling by microarray revealed 1192 preferentially expressed mRNAs and 8841 aberrantly methylated regions between TE-1/R and TE-1 cells. By integrating the mRNA and methylation profiles, we related the decreased expression of transcription factor Sall2 with a corresponding increase in its methylation in TE-1/R cells, indicating its involvement in radioresistance. Upregulation of Sall2 decreased the growth and migration advantage of radioresistant ESCC cells. Taken together, our present findings illustrate the mRNA and DNA methylation changes during the radioresistance of ESCC and the important role of Sall2 in esophageal cancer malignancy.

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“…However, this was not a pure non-surgical trial because approximately 50% of patients in each arm underwent surgery after receiving 40 Gy of radiation. [14] The trial that was designed to deliver adequate doses of systemic chemotherapy with concurrent radiation therapy was the RTOG 85-01 trial[15] reported by Vigneswaran et al .,[16] Herskovic et al . [17] and Al-Sarraf et al .…”

Section: Discussionmentioning

confidence: 99%

A randomized study to compare sequential chemoradiotherapy with concurrent chemoradiotherapy for unresectable locally advanced esophageal cancer

Gupta

Roy

Majumdar

et al. 2014

Indian J Med Paediatr Oncol

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Background:Chemotherapy combined with radiotherapy can improve outcome in locally advanced esophageal cancer.Aim:This study aimed to compare efficacy and toxicity between concurrent chemoradiotherapy (CCRT) and sequential chemoradiotherapy (SCRT) in unresectable, locally advanced, esophageal squamous cell carcinoma (ESSC).Materials and Methods:Forty-one patients with unresectable, locally advanced ESCC were randomized into two arms. In the CCRT arm (Arm A), 17 patients received 50.4 Gy at 1.8 Gy per fraction over 5.6 weeks along with concurrent cisplatin (75 mg m-2 intravenously on day 1 and 5-fluorouracil (1000 mg m-2 continuous intravenous infusion on days 1-4 starting on the first day of irradiation and given after 28 days. In the SCRT arm (Arm B), 20 patients received two cycles of chemotherapy, using the same schedule, followed by radiotherapy fractionated in a similar manner. The endpoints were tumor response, acute and late toxicities, and disease-free survival.Results:With a median follow up of 12.5 months, the complete response rate was 82.4% in Arm A and 35% in Arm B (P = 0.003). Statistically significant differences in frequencies of acute skin toxicity (P = 0.016), gastrointestinal toxicity (P = 0.005) and late radiation pneumonitis (P = 0.002) were found, with greater in the CCRT arm. A modest but non-significant difference was observed in median time to recurrence among complete responders in the two arms (Arm A 13 months and Arm B 15.5 months, P = 0.167) and there was also no significant difference between the Kaplan Meier survival plots (P = 0.641) of disease-free survival.Conclusions:Compared to sequential chemoradiotherapy, concurrent chemoradiotherapy can significantly improve local control rate but with greater risk of adverse reactions.

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Combined chemoradiotherapy vs. radiotherapy alone for early stage squamous cell carcinoma of the esophagus: a study of the eastern cooperative oncology group

Cited by 231 publications

References 17 publications

Update: Modern Approaches to the Treatment of Localized Esophageal Cancer

Update: Modern Approaches to the Treatment of Localized Esophageal Cancer

mRNA and methylation profiling of radioresistant esophageal cancer cells: the involvement of Sall2 in acquired aggressive phenotypes

A randomized study to compare sequential chemoradiotherapy with concurrent chemoradiotherapy for unresectable locally advanced esophageal cancer

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