Final report of Intergroup Trial 0122 (ECOG PE-289, RTOG 90-12): Phase II trial of neoadjuvant chemotherapy plus concurrent chemotherapy and high-dose radiation for squamous cell carcinoma of the esophagus

Minsky, Bruce D.; Neuberg, Donna; Kelsen, David P.; Pisansky, Thomas M.; Ginsberg, Robert J.; Pajak, Thomas F.; Salter, Merle M.; Benson, Al B.

doi:10.1016/s0360-3016(98)00463-5

Cited by 128 publications

(72 citation statements)

References 9 publications

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“…Through several nonrandomized cooperative group trials, concurrent cisplatin (Platinol ® ; Bristol-Myers Squibb, Princeton, NJ, http://www.bms.com)-based chemoradiation or surgery alone represent acceptable standards of care for patients with resectable tumors. Both modalities offer similar rates of local control (60%-90%), 5-year survival (20%-40%), and treatment-related mortality (2%-9%) [9][10][11][12][13][14][15].…”

Section: Standard Treatments Locally Advanced Diseasementioning

confidence: 99%

Targeted Therapies for Esophageal Cancer

2005

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Esophageal cancer is a highly aggressive neoplasm. In 2005, 14,520 Americans will be diagnosed with esophageal cancer, and more than 90% will die of their disease. On a global basis, cancer of the esophagus is the sixth leading cause of cancer death worldwide. In fact, gastric and esophageal cancers together accounted for nearly 1.3 million new cases and 980,000 deaths worldwide in 2000-more than lung, breast, or colorectal cancer. Although esophageal squamous cell carcinoma cases have steadily declined, the incidence of gastroesophageal junction adenocarcinoma has increased 4%-10% per year among U.S. men since 1976, more rapidly than for any other cancer type, and parallels rises in population trends in obesity and reflux disease. With advances in surgical techniques and treatment, the prognosis of esophageal cancer has slowly improved over the past three decades. However, the 5-year overall survival rate (14%) remains poor, even in comparison with the dismal survival rates (4%) from the 1970s. The underlying reasons for this disappointingly low survival rate are multifold: (a) ineffective screening tools and guidelines; (b) cancer detection at an advanced stage, with over 50% of patients with unresectable disease or distant metastasis at presentation; (c) high risk for recurrent disease after esophagectomy or definitive chemoradiotherapy; (d) unreliable noninvasive tools to measure complete response to chemoradiotherapy; and (e) limited survival achieved with palliative chemotherapy alone for patients with metastatic or unresectable disease. Clearly, additional strategies are needed to detect esophageal cancer earlier and to improve our systemic treatment options. Over the past decade, the field of drug development has been transformed with the identification of and ability to direct treatment at specific molecular targets. This review focuses on novel targeted treatments in development for esophageal squamous cell carcinoma and distal esophageal and gastroesophageal junction adenocarcinoma. The Oncologist 2005:590-601Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com CME CME This material is protected by U.S.

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Section: Standard Treatments Locally Advanced Diseasementioning

confidence: 99%

Targeted Therapies for Esophageal Cancer

2005

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“…Using multivariate analysis, M1a node involvement base on the 6th AJCC edition and consolidation chemotherapy were confirmed to be predictive factors for CR after CCRT. According to the previous study, esophageal SCC might have higher metastatic potential than esophageal adenocarcinoma [13]. Therefore, the role of consolidation chemotherapy may be more important in esophageal SCC than esophageal adenocarcinoma although further study will be necessary.…”

Section: Discussionmentioning

confidence: 99%

Local Control May be the Key in Improving Treatment Outcomes of Esophageal Squamous Cell Carcinoma Undergoing Concurrent Chemoradiation

Kim

Lee

et al. 2014

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Background/Aim: Little is known about the patterns of treatment failure following definitive chemoradiotherapy (CCRT), especially in esophageal squamous cell carcinoma (SCC). We evaluated definitive CCRT failure patterns and determined the predictive factors for treatment response in esophageal SCC. Methods: We evaluated 136 consecutive patients with esophageal SCC treated with definitive CCRT. We evaluated the factors associated with complete remission (CR) after CCRT and analyzed the pattern of treatment failure of recurred patients and incomplete remission patients. The failures were categorized as either within (locoregional failure) or outside the radiation field (out-field failure). Results: Fifty-seven patients achieved CR after CCRT. Consolidation chemotherapy was significantly associated with CR. Only 4 (7.0%) patients had CR after CCRT in patients with M1a node (Celiac or subclavian lymph nodes involvement by 6th AJCC). During follow-up, 74 patients (54.4%) experienced locoregional failure, 26 (19.1%) out-field failure, and 35 (25.7%) no failure. Esophageal obstruction prior to CCRT, residual tumor according to the first follow-up endoscopy, and poor follow-up computed tomography responses were significantly associated with locoregional failure. Conclusion: Approximately 70% of treatment failures were local failures. Future therapeutic strategies need to focus on improving local control to increase treatment outcomes of CCRT.

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“…The Intergroup trial documented a median OS of 14.1 months and a 5-year survival rate of 26% in the CT »RT arm (19). Attempts to be more dose intensive in terms of both CT and RT did not result in additional survival advantage with a 5-year OS of 20% (20). The in uence of patient selection on outcome is perhaps best demonstrated in a randomized study from South Africa in which only patients with T3N0-1 stage disease were accrued and were randomized to receive either 2 cycles of CI 5-FU »CDDP and 40 Gy:10 fractions split-course RT or RT alone.…”

Section: Discussionmentioning

confidence: 99%