Clinical results of proton-beam therapy for locoregionally advanced esophageal cancer.
OBJECTIVE
To evaluate the efficacy and safety of proton-beam therapy for locoregionally advanced esophageal cancer.


METHODS
The subjects were 51 patients with esophageal cancer who were treated between 1985 and 2005 using proton beams with or without X-rays. All but one had squamous cell carcinoma. Of the 51 patients, 33 received combinations of X-rays (median 46 Gy) and protons (median 36 GyE) as a boost. The median total dose of combined X-rays and proton radiation for these 33 patients was 80 GyE (range 70-90 GyE). The other 18 patients received proton-beam therapy alone (median 79 GyE, range 62-98 GyE).


RESULTS
Treatment interruption due to radiation-induced esophagitis or hematologic toxicity was not required for any patient. The overall 5-year actuarial survival rate for the 51 patients was 21.1% and the median survival time was 20.5 months (95% confidence interval 10.9-30.2). Of the 51 patients, 40 (78%) showed a complete response within 4 months after completing treatment and seven (14%) showed a partial response, giving a response rate of 92% (47/51). The 5-year local control rate for all 51 patients was 38.0% and the median local control time was 25.5 months (95% confidence interval 14.6-36.3).


CONCLUSIONS
The results suggest that proton-beam therapy is an effective treatment for patients with locally advanced esophageal cancer. Further studies are required to determine the optimal total dose, fractionation schedules, and best combination of proton therapy with chemotherapy.
Mizumoto
Masashi
M
Proton Medical Research Center, University of Tsukuba, Ibaraki, Japan.
Sugahara
Shinji
S
Nakayama
Hidetsugu
H
Hashii
Haruko
H
Nakahara
Akira
A
Terashima
Hideo
H
Okumura
Toshiyuki
T
Tsuboi
Koji
K
Tokuuye
Koichi
K
Sakurai
Hideyuki
H
D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061766:Proton Therapy; D015996:Survival Rate; D016896:Treatment Outcome; D014965:X-Rays; D011522:Protons
D011522:Protons
Jpn J Clin Oncol. 2007 Jul;37(7):493-500
17646277
Clin Cancer Res. 2005 May 15;11(10):3799-805
15897579
Int J Radiat Oncol Biol Phys. 2008 Sep 1;72(1):278-87
18722278
Lancet Oncol. 2005 Sep;6(9):659-68
16129366
Radiother Oncol. 2008 Dec;89(3):287-91
18789828
N Engl J Med. 1998 Dec 31;339(27):1979-84
9869669
Eur J Cardiothorac Surg. 2001 Dec;20(6):1089-94
11717009
J Clin Oncol. 2005 Apr 1;23(10):2310-7
15800321
Int J Radiat Oncol Biol Phys. 2005 Jan 1;61(1):76-84
15629597
Int J Radiat Oncol Biol Phys. 2008 Jun 1;71(2):462-7
18243571
Radiother Oncol. 1996 Nov;41(2):169-77
9004361
JAMA. 1999 May 5;281(17):1623-7
10235156
Int J Radiat Oncol Biol Phys. 1993 Jan;25(1):49-60
8380147
J Clin Oncol. 2001 Jan 15;19(2):305-13
11208820
J Clin Oncol. 2002 Mar 1;20(5):1167-74
11870157
Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):725-34
18164836
Strahlenther Onkol. 2009 Apr;185(4):231-4
19370425
Strahlenther Onkol. 2008 Jan;184(1):15-22
18188518
Int J Radiat Oncol Biol Phys. 2005 Jul 15;62(4):1014-20
15990003
Ann Surg. 1988 Aug;208(2):179-83
2456747
Gut. 2004 Jul;53(7):925-30
15194636
Strahlenther Onkol. 2009 Apr;185(4):211-21
19370423
J Clin Oncol. 2008 Oct 1;26(28):4551-6
18574157
Int J Radiat Oncol Biol Phys. 2002 Sep 1;54(1):131-6
12182982
J Clin Oncol. 2008 Mar 1;26(7):1086-92
18309943
Strahlenther Onkol. 2008 Nov;184(11):586-91
19016017
Semin Radiat Oncol. 2003 Jul;13(3):176-81
12903007
J Clin Oncol. 2003 Jul 15;21(14):2697-702
12860946
Lancet Oncol. 2007 Mar;8(3):226-34
17329193