title: A pilot study of post-operative radiotherapy with concurrent chemotherapy for high-risk squamous cell carcinoma of the cervical esophagus.
abstract: OBJECTIVE
  After complete resection of carcinomas of the head and neck, including carcinoma of the cervical esophagus, the pattern of first failure is more often locoregional than distant metastasis. We retrospectively evaluated the safety and efficacy of the combination of post-operative radiation and concurrent chemotherapy with low-dose cisplatin for high-risk squamous cell carcinoma of the cervical esophagus.
  
  
  METHODS
  From 2005 through 2008, 34 patients with previously untreated squamous cell carcinoma of the cervical esophagus underwent cervical esophagectomy with or without laryngectomy. Of these 34 patients, 11 with disease-positive lymph nodes in the upper mediastinum (M1 lymph/Stage IV) confirmed by pathologic examination were enrolled. Patients received radiotherapy (66 Gy in 33 fractions) and concurrent low-dose cisplatin.
  
  
  RESULTS
  Nine patients completed the planned radiotherapy and two or more courses of chemotherapy. Grade 3 toxicities during chemoradiotherapy were leukopenia (36% of patients), neutropenia (18%) and mucositis (9%). At a median follow-up time of 39.5 months, the overall 1- and 3-year survival rates were 91 and 71%, respectively.
  
  
  CONCLUSIONS
  The combination of post-operative radiation and concurrent chemotherapy with low-dose cisplatin is well tolerated and has the potential to improve the rates of locoregional control and overall survival in patients with high-risk advanced squamous cell carcinoma of the esophagus.
authors.affiliation: Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. hdaikou@east.ncc.go.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daiko
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ebihara
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinozaki
authors.forename: Masahisa
authors.initials: M
authors.lastname: Saikawa
authors.forename: Sadatomo
authors.initials: S
authors.lastname: Zenda
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Kawashima
authors.forename: Makoto
authors.initials: M
authors.lastname: Tahara
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Doi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ohtsu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000209:etiology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D009333:Neck; D009367:Neoplasm Staging; D009503:Neutropenia / Q000209:etiology; D010865:Pilot Projects; D011184:Postoperative Period; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin