title: Late toxicity in complete response cases after definitive chemoradiotherapy for esophageal squamous cell carcinoma.
abstract: 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.
authors.affiliation: Second Department of Internal Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kumekawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kaneko
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ito
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kurahashi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Konishi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Katagiri
authors.forename: Taikan
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Meiko
authors.initials: M
authors.lastname: Kuwahara
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Kubota
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramoto
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Mizutani
authors.forename: Michio
authors.initials: M
authors.lastname: Imawari
mesh_terms: 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*
chemical_list: D002945:Cisplatin; D005472:Fluorouracil