Chemoradiation for esophageal cancer: institutional experience with three different regimens.
OBJECTIVE
The aim of this study was to retrospectively evaluate toxicity and efficacy of 3 chemoradiation regimens.


METHODS
Between 1997 and 2007, 94 patients with esophageal cancer were treated with chemoradiation in our institute. Treatment consisted of radiotherapy to 50 Gy in 25 fractions with concurrent cisplatin and 5-fluorouracil (group A, n = 65), radiotherapy to 50.4 Gy in 28 fractions with concurrent carboplatin and paclitaxel (group B, n = 16) or radiotherapy to 66 Gy in 33 fractions with low-dose cisplatin (group C, n = 13). Toxicity was scored according to Common Terminology Criteria version 3.0.


RESULTS
Chemoradiation was planned as neoadjuvant (n = 58) or definitive (n = 36) treatment. Grade 3/4 hematological toxicity occurred in 18 (19%) patients and grade 3 nonhematologic toxicity in 8 (9%) patients. During treatment, 2 patients died (1 from duodenal ulcer bleeding and 1 from stroke). Overall, 81 (86%) patients completed the planned treatment (86%, 94%, and 77% in groups A, B, and C, respectively). Clinically complete or partial response was observed in 28 of 92 (30%) patients (21%, 50%, and 54% in groups A, B, and C, respectively). After clinical and radiologic response evaluation, treatment plan was changed in 14 (15%) patients. A total of 45 patients underwent surgery. Pathologic complete response and downstaging were seen in 12 (27%) and 34 (76%) operated patients, respectively. With a median follow-up of 15 (range, 1-108) months, the 3-year survival was 41% for all patients.


CONCLUSIONS
With individual treatment planning, different regimens of chemoradiation for esophageal cancer resulted in acceptable rates of toxicity and efficacy.
Courrech Staal
Ewout F W
EF
Department of Surgical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. e.courrech@nki.nl
Aleman
Berthe M P
BM
van Velthuysen
Marie-Louise F
ML
Cats
Annemieke
A
Boot
Henk
H
Jansen
Edwin P M
EP
van Coevorden
Frits
F
van Sandick
Johanna W
JW
D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017239:Paclitaxel / Q000008:administration & dosage; D011878:Radiotherapy; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D005472:Fluorouracil