Outcomes of concurrent chemoradiotherapy versus chemotherapy alone for esophageal squamous cell cancer patients presenting with oligometastases Journal Article
| Authors: | Chen, Y.; Cheng, X.; Song, H.; Wu, A. J.; Ku, G. Y.; Lee, P.; Slingerland, M.; Koyanagi, K.; Ke, S.; Qiu, H.; Shi, W.; Gao, Y.; Chen, J.; written on behalf of the AME Radiation Oncology Collaborative Group |
| Article Title: | Outcomes of concurrent chemoradiotherapy versus chemotherapy alone for esophageal squamous cell cancer patients presenting with oligometastases |
| Abstract: | Background: The potential survival benefits of adding radiotherapy to systemic therapy for esophageal cancer patients with oligometastases are unknown. Methods: In this retrospective analysis, patients with stage IV esophageal cancer (according to the American Joint Committee on Cancer Seventh edition staging system) with ≤3 metastases who underwent chemotherapy with cisplatin/paclitaxel between 2012 and 2015 were identified. Patients received chemotherapy (CT) alone vs. concurrent chemoradiotherapy (CCRT) to all metastases. Results: Of 461 patients, 97% had squamous cell cancer. One hundred and ninety-six patients (42.5%) received CCRT and 265 (57.5%) underwent CT alone. At week 8, there were 3 (1.5%) complete responses (CR) and 95 (48.5%) partial responses (PR) in the CCRT group, compared to 3 (1.1%) CR and 102 (38.5%) PR in the CT alone group. The overall rate of improvement in dysphagia score was noted in 78.5% of patients in the CCRT group versus 61.5% in the CT alone group (P=0.014). A statistically significant difference was demonstrated in disease control rate between the two groups (81.6% vs. 64.5%, P<0.001). Patients who underwent CCRT had superior median PFS and a trend toward longer median OS compared to those receiving CT alone (8.7 vs. 7.3 months, P=0.002 and 16.8 vs. 14.8 months, P=0.056, respectively). The median OS was 19.3 months in patients who achieved CR/PR, compared to 14.9 months and 9.6 months for patients who had stable disease and progressive disease, respectively (P<0.001). Conclusions: Compared to chemotherapy alone, chemoradiation to all sites in patients with esophageal cancer with ≤3 metastases may lead to a modest increase in PFS and a trend toward longer OS. Further investigation of optimal integration of radiotherapy and chemotherapy in these patients is warranted. © Journal of Thoracic Disease. All rights reserved. |
| Keywords: | radiotherapy; esophageal cancer; advanced disease; prognosis; systemic treatment |
| Journal Title: | Journal of Thoracic Disease |
| Volume: | 11 |
| Issue: | 4 |
| ISSN: | 2072-1439 |
| Publisher: | Pioneer Bioscience Publishing Company |
| Date Published: | 2019-04-01 |
| Start Page: | 1536 |
| End Page: | 1545 |
| Language: | English |
| DOI: | 10.21037/jtd.2019.03.10 |
| PROVIDER: | scopus |
| PMCID: | PMC6531702 |
| PUBMED: | 31179097 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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