Late toxicity in complete response cases after definitive chemoradiotherapy for esophageal squamous cell carcinoma.
BACKGROUND
We retrospectively investigated long-term toxicity after concurrent chemoradiotherapy (CRT) for patients with esophageal squamous cell carcinoma (ESCC).


METHODS
Concurrent chemoradiotherapy was performed in 110 patients with T1 to T4 disease containing M1 lymph node (LYM) disease. Chemotherapy consisted of protracted infusion of 5-fluorouracil 400 mg/m(2) per 24 h on days 1 to 5 and 8 to 12, combined with 2-h infusion of cisplatin 40 mg/m(2) on days 1 and 8. Radiation treatment of the mediastinum at a dose of 30 Gy in 15 fractions was administered concomitantly with chemotherapy. A course schedule with a 3-week treatment and a 2-week break was applied twice, with a total radiation dose of 60 Gy. For the assessment of toxicity, the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring schema was adopted.


RESULTS
A total of 81 patients were recruited in patients with stage I to IVA. Of 34 patients with complete response, 1 patient died as a result of acute myocardial infarction. Grade 2, 3, and 4 late toxicities occurred with the following incidences: pericarditis in 3 patients, 1 patient, and 2 patients, respectively; heart failure in 0, 0, and 3 patients; pleural effusion in 2, 3, and 0 patients; and radiation pneumonitis in 0, 0, and 1 patient, respectively.


CONCLUSIONS
Definitive chemoradiotherapy for ESCC is effective with substantial toxicities. Further investigation is warranted to minimize the normal tissue toxicities.
Kumekawa
Yosuke
Y
Second Department of Internal Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.
Kaneko
Kazuhiro
K
Ito
Hiroaki
H
Kurahashi
Toshinori
T
Konishi
Kazuo
K
Katagiri
Atsushi
A
Yamamoto
Taikan
T
Kuwahara
Meiko
M
Kubota
Yutaro
Y
Muramoto
Takashi
T
Mizutani
Yoshihide
Y
Imawari
Michio
M
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D018579:Patient Selection; D010493:Pericarditis / Q000453:epidemiology / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects*
D002945:Cisplatin; D005472:Fluorouracil