Radio(chemo)therapy for locally advanced squamous cell carcinoma of the esophagus

Ordu, Arif Deniz; Nieder, Carsten; Geinitz, Hans; Kup, Philipp Günther; Deymann, Lisa Felicia; Scherer, Vera; Combs, Stephanie E.; Fakhrian, Khashayar

doi:10.1007/s00066-014-0779-x

Cited by 15 publications

(13 citation statements)

References 20 publications

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“…The most common cancer-related complication in these patients is dysphagia with an increasing rate as the disease progresses, leading to nutritional compromise, pain, reduced performance status and deterioration of quality of life 3 , 4 . Many of these patients with severe clinical symptoms are not fit enough to undergo surgical resection or curative radiochemotherapy 5 , 6 . The latter approaches are not suitable for patients with distant metastases either 7 .…”

Section: Introductionmentioning

confidence: 99%

Survival and Symptom Relief after Palliative Radiotherapy for Esophageal Cancer

Welsch¹,

Kup²,

Nieder³

et al. 2016

J. Cancer

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Purpose: The aim of this study was to assess the 6-months dysphagia-free survival, improvement in swallowing function, complication rate, and overall survival in patients with incurable esophageal cancer treated with palliative radiotherapy.Methods: We retrospectively reviewed data from 139 patients (median age 72 years) with advanced/recurrent incurable esophageal cancer, who were referred to 3 German radiation oncology centers for palliative radiotherapy between 1994 and 2014. Radiotherapy consisted of external beam radiotherapy (EBRT) with 30 - 40.5 Gy/2.5 - 3 Gy per fraction, brachytherapy alone (BT) with 15 - 25 Gy/5 - 7Gy per fraction/weekly and EBRT + BT (30 - 40.5 Gy plus 10 - 14 Gy with BT) in 65, 46, and 28 patients, respectively. Dysphagia-free survival (Dy-PFS) was defined as the time to worsening of dysphagia for at least one point, a new loco-regional failure or death of any cause.Results: Median follow-up time was 6 months (range 1-6 months). Subjective symptom relief was achieved in 72 % of patients with median response duration of 5 months. The 1-year survival rate was 30%. The 6-months Dy-PFS time for the whole group was 73 ± 4%. The 6-months Dy-PFS was 90 ± 4% after EBRT, 92 ± 5% after EBRT + BT and 37 ± 7% after BT, respectively (p<0.001). Five patients lived for more than 2 years, all of them were treated with EBRT ± BT. Ulceration, fistula and stricture developed in 3, 6 and 7 patients, respectively.Conclusions: Radiotherapy leads to symptom improvement in the majority of patients with advanced incurable esophageal cancer. The present results favor EBRT ± BT over BT alone. Due to the retrospective nature of this study, imbalances in baseline characteristics might have contributed to this finding, and further trials appear necessary.

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Section: Introductionmentioning

confidence: 99%

Survival and Symptom Relief after Palliative Radiotherapy for Esophageal Cancer

Welsch¹,

Kup²,

Nieder³

et al. 2016

J. Cancer

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“…However, at later developmental stages, surgical anastomosis is performed using Kirschne-Akiyama gastric tube or fundus rotation gastroplasty techniques (7). In cases of unresectable EC, patients are treated with a combination of chemo-and radiotherapy (8). Laser therapy may also be used as an effective method for improving the patient's ability to swallow (9).…”

Section: Introductionmentioning

confidence: 99%

Expression of MMP9, SERPINE1 and miR-134 as prognostic factors in esophageal cancer

et al. 2016

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Abstract. Esophageal cancer (EC) is a malignant tumor with a typically poor prognosis for patients. It is well known that certain microRNA (miRNA/miR) genes can regulate other genes responsible for carcinogenesis. In the present study, a group of these genes (miR-21, miR-134, miR-205 and miR-495) and genes connected with cancer-related pathways (MET, MMP9, PDGFA and SERPINE1) were chosen for analysis in order to find a potential correlation between their expression and the clinicopathological factors of EC. Esophageal tumors and adjacent non-cancerous tissue specimens were collected from a total of 63 patients and embedded in paraffin. Commercial arrays were used on KYSE-30, KYSE-150 and KYSE-270 EC cell lines in order to find genes of different expression profiles compared with those acquired from the control Het-1A cell line. Quantitative polymerase chain reaction was used on formalin-fixed, paraffin-embedded samples in order to analyze the expression of the genes chosen in the earlier step. The results were analyzed by the Kruskal-Wallis and Mann-Whitney U tests, Spearman's rank correlation coefficient, Kaplan-Meier methods and the long-rank test. Only miR-495 was not expressed in the analyzed samples. The expression of MMP9 and SERPINE1 was significantly coefficient with age range (P=0.011 and P=0.044, respectively) according to the Kruskal-Wallis test. The Spearman's rank-order correlation measurement showed that there was a coefficient correlation between age and miR-134 expression. The same measurement demonstrated a correlation between age range and MMP9 expression. The expression of miR-134 and MMP9 were also found to be correlated. In all cases, a value of P<0.049 was recorded. Overall, the present study demonstrated that MMP9, SERPINE1 and miR-134 were the most prognostic genes in Caucasian patients with EC.

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“…Esophageal cancer is the 6 th most common cause of cancer deaths worldwide because of its high malignant potential and poor prognosis [1]. Locoregional recurrence (LR) is the major type of failure form in 24-50% of the patients after initial therapy such as surgery and/or chemoradiotherapy (CRT) [2,3], and in-eld relapse after radiotherapy (RT) occurred in more than 20 % of patients [4,5]. The 5-year survival rate drops dramatically down to 0-11% once recurrence occurs [6,7].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Toxicity of Re-irradiation for Esophageal Cancer Patients with Locoregional Recurrence: a retrospective analysis

Zhao

Sun

et al. 2020

Preprint

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Introduction: There is no standard treatment for locoregional recurrent (LR) esophageal squamous cell carcinoma (ESCC) patients treated with radiotherapy (RT) previously. This retrospective study aimed to examine the efficacy and toxicity of re-irradiation (re-RT) for ESCC patients with LR. Patients and Methods: A total of 252 patients were enrolled. Gross tumor volumes for re-RT were defined using contrast enhanced computed tomography and/or positron emission tomography/computed tomography. Overall survival (OS), after recurrence survival (ARS) and toxicities were assessed. Results: Through a median follow-up of 38 months, the median OS and ARS were 39.0 and 13.0 months, respectively. The 6-, 12-, and 24-month ARS rates were 81.9%, 50.5%, and 21.8%, respectively. Multivariate analyses showed that chemotherapy, esophageal stenosis and RFI may be independent prognostic factors for ARS. The incidence of esophageal fistula/ perforation, radiation-induced pneumonitis and esophagorrhagia was 21.4%, 12.8% and 9.1%, respectively. RFI≤12 months, esophageal stenosis and fat space between tumor and adjacent tissue disappeared were independent risk factors for the development of EP after re-RT. Conclusions: Re-RT was feasible for LR ESCC patients after RT initially, the complications occurred in re-RT is acceptable. Patients with RFI≤12 months, esophageal stenosis and fat space between tumor and adjacent tissue disappeared should be closely observed during and after re-RT.

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Radio(chemo)therapy for locally advanced squamous cell carcinoma of the esophagus

Cited by 15 publications

References 20 publications

Survival and Symptom Relief after Palliative Radiotherapy for Esophageal Cancer

Survival and Symptom Relief after Palliative Radiotherapy for Esophageal Cancer

Expression of MMP9, SERPINE1 and miR-134 as prognostic factors in esophageal cancer

Efficacy and Toxicity of Re-irradiation for Esophageal Cancer Patients with Locoregional Recurrence: a retrospective analysis

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