Involved field irradiation for the treatment of esophageal cancer: Is it better than elective nodal irradiation?

Jiang, Liyang; Zhao, Xin; Meng, Xue; J, Yu

doi:10.1016/j.canlet.2014.11.045

Cited by 24 publications

(20 citation statements)

References 52 publications

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“…The prognosis of EC is unfavorable, largely due to its unapparent symptom at the early stage and tumor infiltration and metastasis which makes it hard to completely remove the tumor by surgery[3]. Therefore, it is with great significance to study the molecular mechanism in the development, invasion and metastasis of EC.…”

Section: Introductionmentioning

confidence: 99%

The prognostic and clinicopathologic characteristics of CD147 and esophagus cancer: A meta-analysis

Jiang

et al. 2017

PLoS ONE

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ObjectiveThe prognostic significance of CD147 expression in esophageal cancer patients remains controversial. Using a meta-analysis, we investigated the prognostic and clinicopathologic characteristics of CD147 in esophageal cancer.MethodsA comprehensive literature search of the PubMed (1966–2016), EMBASE (1980–2016), Cochrane Library (1996–2016), Web of Science (1945–2016), China National Knowledge Infrastructure (1982–2016), and Wanfang databases (1988–2016) was performed to identify studies of all esophageal cancer subtypes. Correlations between CD147 expression and survival outcomes and clinicopathological features were analyzed using meta-analysis methods.ResultsSeventeen studies were included. High CD147 expression reduced the 3-year survival rate (OR = 3.26, 95% CI = (1.53, 6.93), p = 0.02) and 5-year survival rate(OR = 4.35, 95% CI = (2.13, 8.90), p < 0.0001). High CD147 expression reduced overall survival in esophageal cancer (HR = 1.60, 95% CI = (1.19, 2.15), p = 0.02). Additionally, higher CD147 expression was detected in esophageal cancer tissues than noncancerous tissues (OR = 9.45, 95% CI = (5.39, 16.59), p < 0.00001), normal tissues (OR = 12.73, 95% CI = (3.49, 46.46), p = 0.0001), para-carcinoma tissues (OR = 12.80, 95% CI = (6.57, 24.92), p < 0.00001), and hyperplastic tissues (OR = 3.27, 95% CI = (1.47, 7.29), p = 0.004). CD147 expression was associated with TNM stage (OR = 3.66, 95% CI = (2.20, 6.09), p < 0.00001), tumor depth (OR = 7.97, 95% CI = (4.13, 15.38), p < 0.00001), and lymph node status (OR = 5.14, 95% CI = (2.03,13.01), p = 0.0005), but not with tumor differentiation, age, or sex.ConclusionOur meta-analysis suggests that CD147 is an efficient prognostic factor in esophageal cancer. High CD147 expression in patients with esophageal cancer was associated with worse survival outcomes and common clinicopathological indicators of poor prognosis.

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Section: Introductionmentioning

confidence: 99%

The prognostic and clinicopathologic characteristics of CD147 and esophagus cancer: A meta-analysis

Jiang

et al. 2017

PLoS ONE

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“…[30][31][32][33] Furthermore, some studies had proved that survival benefits could acquire by patients with a histological CR. [34][35][36] Another report in 2014 conducted by Lin et al at MD Anderson Cancer Center also confirmed this opinion used with a nomogram and they had the conclusion that the pCR nomogram score could predict survival outcomes in patients receiving CCRT for EC. 37 Regardless of the histological subtype, EC is notorious for its submucosal skip invasion because of the extensive and longitudinal interconnecting system of lymphatics in the esophageal wall.…”

Section: Discussionmentioning

confidence: 56%

“…13 With developments of radiation technology, IMRT and volumetric intensity modulated arc therapy (VMAT) are implemented for sparing normal organs and tight PTV planning but will not provide unintended ENI as with conformal planning. 36,38 An obvious trend of using modern radiation technology has been shown in Table 1 (from conventional RT to IMRT) and an advantage of 3-year OS rate was observed for patients treated with 3D-CRT/IMRT. Liu et al had also indicated that with better protection of normal organs and attention to select appropriate patients, no difference could be found in the incidences of Grade 3 treatment-related esophageal and lung toxicities between ENI and IFI groups with the application of IMRT.…”

Section: Discussionmentioning

confidence: 96%

Concurrent chemoradiotherapy with elective lymph node irradiation for esophageal cancer: a systemic review and pooled analysis of the literature

Song

Liang

et al. 2016

Diseases of the Esophagus

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Concurrent chemoradiotherapy (CCRT) has been accepted as the standard non-surgical treatment for esophageal cancer. However, no consistent conclusions have been reached whether elective lymph node irradiation (ENI) should be delivered. Therefore, we performed a systematic review and pooled analysis to evaluate the value of CCRT with ENI. A literature search based on PubMed, Embase and Google Scholar was carried out and all of the studies were evaluated carefully regarding with survival outcomes, response rates, patterns of failure rates and acute/late toxicities. Twenty-two studies were identified based on the criteria: median overall survival time was 21.0 months; pooled response rates were 56.8% (CR) and 85.8% (CR+PR), respectively; residual disease rate, local-regional recurrence rate, distant failure rate and both (local-regional recurrence plus distant failure) rate was 28%, 21%, 11%, and 7%, respectively; hematologic toxicities were the most sever acute toxicities and esophagus-related toxicity was the most common radiation-related toxicity both in acute (15.7%) and late (6.2%) phase. In conclusion, ENI is feasible with acceptable toxicities in esophageal carcinoma and the efficacy should be verified in randomized trials.

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“…Therefore, the RLN chains and supraclavicular/cervical region treatment should be prophylactically covered if not already involved, as evidenced by the fact that patients receiving ENI had significantly better RFFS than those receiving IFI. Although the need for elective coverage of the supraclavicular and upper mediastinal regions is still somewhat controversial [31, 32], the nodal metastatic patterns after surgery and RT [5, 33, 34], as well as data from the current study, suggest prophylactic irradiation of the supraclavicular and upper mediastinal RLN chains regions should be recommended.…”

Section: Discussionmentioning

confidence: 99%

Patterns of failure and clinical outcomes of definitive radiotherapy for cervical esophageal cancer

Zhao

Zhou

et al. 2017

Oncotarget

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PurposeBecause of the scarcity of cervical esophageal cancer (CEC), data for this disease entity is limited. We aim to evaluate the outcomes, prognostic factors and failure patterns of CEC treated by contemporary radiotherapy (RT).MethodsWe retrospectively analyzed 86 CEC patients consecutively treated between 2007 and 2015 by definitive RT with or without concurrent chemotherapy. RT was mainly delivered with Intensity Modulated Irradiation Therapy (IMRT) or Volumetric-Modulated Arc Therapy (VMAT). Statistical analyses were performed on survival, prognostic factors and failure patterns.ResultsThe median follow-up time was 19.4 months. The 3-year overall survival (OS), local regional failure free survival (LRFFS), distant metastatic free survival (DMFS), and progression free survival (PFS) were 53.6%, 57.9%, 81.5% and 41.5%, respectively. Independent predictors for poorer OS were N stage, hoarseness and recurrent laryngeal nerve lymph node (RLN) involvement, and predictors for LRFFS were N stage and EQD2 (equivalent dose in 2 Gy fraction) to gross tumor volume (GTV), with ≥ 66Gy achieving local control of 94.7%. Patients receiving elective nodal irradiation (ENI) had better nodal regional control than those receiving involved field irradiation (IFI). 31 (36%) patients had treatment failure and 15 (17.4%), 8 (9.3%) and 14 (16.2%) patients had local, regional, and distant failure, respectively. 86.7% (13/15) local failures were within GTV, and supraclavicular region (62.5%, 5/8) was the most common regional failure site. No severe toxicities were observed.ConclusionsOur results seem to indicate that good locoregional control might be achieved for CEC with adequate radiation dose and treatment planning approaches.

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Involved field irradiation for the treatment of esophageal cancer: Is it better than elective nodal irradiation?

Cited by 24 publications

References 52 publications

The prognostic and clinicopathologic characteristics of CD147 and esophagus cancer: A meta-analysis

The prognostic and clinicopathologic characteristics of CD147 and esophagus cancer: A meta-analysis

Concurrent chemoradiotherapy with elective lymph node irradiation for esophageal cancer: a systemic review and pooled analysis of the literature

Patterns of failure and clinical outcomes of definitive radiotherapy for cervical esophageal cancer

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