Induction Chemotherapy Followed by Concurrent Chemotherapy and High-Dose Radiotherapy for Locally Advanced Squamous Cell Carcinoma of the Upper-thoracic and Midthoracic Esophagus
作者:
Martin Stuschke,
Michael Stahl,
Hansjochen Wilke,
Martin Walz,
Anneruth Oldenburg,
Georg Stüben,
Siegfried Seeber,
Horst Sack,
期刊:
American Journal of Clinical Oncology: Cancer Clinical Trials
(OVID Available online 2000)
卷期:
Volume 23,
issue 3
页码: 233-238
ISSN:0277-3732
年代: 2000
出版商: OVID
关键词: Esophageal cancer;Induction chemotherapy;Concurrent radiochemotherapy;Brachytherapy;Accelerated hyperfractionated radiotherapy.
数据来源: OVID
摘要:
The purpose of this study was to evaluate the efficacy and toxicity of an induction chemotherapy schedule followed by high-dose radiotherapy and concurrent chemotherapy for locally advanced squamous cell carcinomas of the upper and midthoracic esophagus. Patients were treated with three courses of fluorouracil, leucovorin, etoposide, and cisplatin-containing induction chemotherapy followed by high-dose external beam radiotherapy to 65 Gy in 6 weeks for T4 and obstructing T3 tumors. Transversable T3 tumors received 60 Gy in 6 weeks by external radiotherapy, followed by two high-dose-rate esophageal brachytherapy fractions of 4 Gy in 5-mm tissue depth. Concurrent to radiotherapy, cisplatin and etoposide were given. Long-term survival of 22 patients was 41% and 31% at 2 and 3 years, respectively, with a median follow-up of 39 months. The probability of locoregional tumor recurrence was 60% at 3 years for all patients and 30% for those with a partial or complete response to induction chemotherapy. Acute toxicity of this schedule was moderate. Long-term survivors had a good swallowing function. This schedule offers a considerable chance of long-term survival for patients with locally advanced squamous cell carcinomas of the upper and midthoracic esophagus. Local in-field recurrences are the main risk after definitive radiochemotherapy. Dose escalation of radiotherapy is possible because of the observed low late toxicity.
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