title: Results of chemoradiotherapy for stage I esophageal cancer in medically inoperable patients compared with results in operable patients.
abstract: The purpose of the present study was to evaluate long-term results of chemoradiotherapy for clinical T1b-2N0M0 esophageal cancer and to compare outcomes for operable and inoperable patients. Patients with stage I esophageal cancer (Union for International Cancer Control [UICC] 2009), excluding patients with cT1a esophageal cancer, were studied. All patients had histologically proven squamous cell carcinoma. Operable patients received cisplatin and 5-fluorouracil with concurrent radiotherapy of 60 Gy including a 2-week break. Inoperable patients received nedaplatin and 5-fluorouracil with concurrent radiotherapy of 60-70 Gy without a pause. End-points were overall survival rate (OS), cause-specific survival rate (CSS), progression-free survival rate (PFS), and locoregional control rate (LC). Thirty-seven operable patients and 30 medically inoperable patients were enrolled. There was a significant difference in only age between the operable group and inoperable group (P = 0.04). The median observation period was 67.9 months. In all patients, 5-year OS, CSS, PFS, and LC were 77.9%, 91.5%, 66.9%, and 80.8%, respectively. Comparison of the operable group and inoperable group showed that there was a significant difference in OS (5-year, 85.5% vs. 68.7%, P = 0.04), but there was no difference in CSS, PFS, or LC. Grade 3 or more late toxicity according to Common Terminology Criteria for Adverse Events v 3.0 was found in seven patients. Even in medically inoperable patients with stage I esophageal cancer, LC of more than 80% can be achieved with chemoradiotherapy. However, OS in medically inoperable patients is significantly worse than that in operable patients.
authors.affiliation: Department of Radiation Oncology, Tohoku University School of Medicine, Sendai 980-8574, Japan. kjingu-jr@rad.med.tohoku.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Jingu
authors.forename: H
authors.initials: H
authors.lastname: Matsushita
authors.forename: K
authors.initials: K
authors.lastname: Takeda
authors.forename: K
authors.initials: K
authors.lastname: Narazaki
authors.forename: H
authors.initials: H
authors.lastname: Ariga
authors.forename: R
authors.initials: R
authors.lastname: Umezawa
authors.forename: T
authors.initials: T
authors.lastname: Sugawara
authors.forename: G
authors.initials: G
authors.lastname: Miyata
authors.forename: K
authors.initials: K
authors.lastname: Onodera
authors.forename: K
authors.initials: K
authors.lastname: Nemoto
authors.forename: S
authors.initials: S
authors.lastname: Yamada
mesh_terms: D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D016629:Esophagectomy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D015996:Survival Rate
chemical_list: D009944:Organoplatinum Compounds; C053989:nedaplatin; D002945:Cisplatin; D005472:Fluorouracil