Definitive Chemoradiation for Oesophageal Cancer — a Standard of Care in Patients with Non-metastatic Oesophageal Cancer

Survival in Patients Treated with Definitive Chemo-Radiotherapy for Non-Metastatic Esophageal Cancer in North-West Iran

“…This result could be explained by the fact that Iranian patients generally seek a medical advice with a delay and the diagnosis is made when the disease has reached an advanced stage (Ghadimi et al, 2011).This study revealed that, aging was one of the risk factors (P=0.02; OR=1.46 by the cox regression analysis) and again age was inversely associated with the survival rate (P=0. 01), which is consistent with previous studies (Aghcheli et al, 2011;Ghadimi et al, 2011).We showed that nodal stage was an important prognostic factor; this was reported from another studies as well (P=0.04) (Gwynne et al, 2011;Semrau et al, 2012).Result in the current study did not show any statistical significance according to histology this is consistent with several prior studies (Gwynne et al, 2011;Semrau et al, 2012).There was no statistically significant difference in gender and tumors site of the upper, middle or lower esophagus this is consistent with other studies respectively (Byun et al, 2011;Semrau et al, 2012). Higher doses of radiation, was one of the Protective factors (P=0.005; OR=0.62 by the cox regression analysis) and was associated with a higher survival rate (P<0.001), as report by other study and may improve local control as well as survival (Byun et al, 2011;Gwynne et al, 2011;Semrau et al, 2012).We found a significant survival advantage for patients who received a combination of CT and RT as compared with RT alone (p=0.03), this is consistent with other report (Semrau et al, 2012).Results of our study were limited by the lack of recorded toxicity data in a standardized fashion.…”

“…Unfortunately, patients suffering from esophageal cancer often refer to medical care when it is unfit for surgery or having irresectable tumors and so DCRT to treat them. In our study, the one, three and the five year survival rates were 55, 18 and 11%, respectively which are slightly lower as compared to those reported from other studies (Gwynne et al, 2011;Motoori et al, 2012;Semrau et al, 2012). This result could be explained by the fact that Iranian patients generally seek a medical advice with a delay and the diagnosis is made when the disease has reached an advanced stage (Ghadimi et al, 2011).This study revealed that, aging was one of the risk factors (P=0.02; OR=1.46 by the cox regression analysis) and again age was inversely associated with the survival rate (P=0.…”

“…DCRT as primary treatment modality is offered to esophageal cancer patients, as an alternative for patients considered medically unfit for surgery or having irresectable tumors (Smit et al, 2012). Although DCRT has not been compared directly with surgery in randomized trials, outcomes from published studies are similar to those seen in surgical trials in terms of survival and quality of life (Gwynne et al, 2011). Despite 45 years of the establishment of the regional center of RT, the effect of DCR in survival patients with esophageal cancer has been unknown.…”

Effect of extending the original eligibility criteria for the “CROSS” neoadjuvant chemoradiotherapy on toxicity and survival in esophageal cancer.

“…However, the groups were too small for a solid conclusion. Davies et al 10 found that celiac lymph node metastasis (determined by endoscopic ultrasound) was not prognostic for OS after dCRT, which was confirmed by Gwynne et al 13 However, further research seems necessary to elucidate the value of dCRT for patients with celiac lymph node metastasis, probably in a randomized controlled trial or a large retrospective study.…”

“…The median survival after noninvasive dCRT, an alternative for patients with considerable comorbidity, is 16-21 months, raising the question whether dCRT is worth considering for the extended patient category. [10][11][12][13] Nevertheless, direct comparison of survival rates in the dCRT and extended CROSS group is not possible because dCRT studies also included irresectable tumors and inoperable patients.…”