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Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment for advanced esophageal cancer, but it may be more invasive in the elderly and definitive radiotherapy (RT) alone may be selected. This study assessed the significance of sequential chemoradiotherapy (SCRT) in elderly esophageal cancer patients. Methods: We reviewed 87 patients aged 75 years and older, who were treated using definitive radiotherapy without concurrent chemotherapy for esophageal cancer. A total dose ranging from 50.4 to 63 Gy (median, 58.8) was delivered to the primary lesion and the involved lymph nodes. This study compared patients who received SCRT with those who received RT alone among 40 patients with stage III or IVA cancer. Descriptive statistics were calculated using Cox proportional hazards regression analysis and the generalized Wilcoxon test. Results: The total progression?free survival (TPFS), progression?free survival outside the irradiation field, and overall survival were significantly longer after SCRT (n = 15) than after definitive RT alone (n = 25; P = 0.0041 and 0.0098), whereas the progression?free survival in the irradiation field was not significantly different between the two groups. The TPFS was significantly shorter in patients who received RT alone than in those who received SCRT (P = 0.0372). There were no grade 4 or higher adverse events in the patients who received SCRT. Conclusion: SCRT was associated with a reduced relapse rate, suggesting that it should be considered for markedly elderly patients with advanced esophageal cancer.
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Background: Outcome of various treatment regimen are dismal in non-small cell lung cancer. This analysis is done to find possible care in authors institutional set up and to see how these protocols have effect in Indian patients in term of toxicity.Methods: Medical records and data on patients who had been diagnosed with non-small cell lung cancer histologically or cytologically, and who had been treated with sequential chemoradiation and concurrent chemoradiation at the hospital from January 2007 to March 2015 was retrospectively reviewed and analyzed. Two groups of sequential chemoradiotherapy and concurrent chemoradiotherapy were formed and compared for outcomes.Results: Of the 114 evaluable patients in sequential chemoradiotherapy group, the median survival time was 16.0 months and the 1, 3- and 5-years overall survival were 57.0, 26.9 and 21.2%, respectively. Median progression free survival (PFS was 13.0 months and the 1, 3 and 5 years PFS were 52.6, 14.6 and 7.8%, respectively. In concurrent chemoradiotherapy group (105 patients), the overall median survival time was 15 months and the 1, 3- and 5-year overall survival were 56.2, 20.6 and 14.7%, respectively. Median PFS was 13 months and the 1, 3 and 5-year PFS were 48.8, 19.7 and 10.3%, respectively. Grade 3 and 4 toxicity in both regimen groups are same and statistically not significant.Conclusions: Analysis confirm dismal outcome with standard treatment and signifies to search for care beyond conventional chemoradiotherapy.
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Objective To analyze the curative effect and toxicity of concurrent chemoradiotherapy and sequential chemoradiotherapy in non-small cell lung cancer patients.Methods 64 patients with unresectable stage Ⅲ non-small cell lung cancer in our hospital between May 2010 and Mar 2013 were randomly assigned into concurrent group and sequential group for this test.Concurrent group patients (32 cases) were given Cisplatin and Gemcitabine on the 1,4,7 week during radiotherapy.Sequential group patients accepted 3 cycles chemotherapy before radiotherapy.Results The response rate was 68.8％ in concurrent group,and 43.8％ in sequential group.Difference was significant between the response rates of the two groups (P ＜ 0.05).There was significant difference in haematological toxicity,which was 100％ in concurrent group and 65.6％ in sequential group (P ＜ 0.05).There was no significant difference in rates of radiation pneumonia and radiation esophagitis in the two groups (P ＞ 0.05) Conclusions Concurrent chemoradiotherapy has better curative effect than sequential chemoradiotherapy.Concurrent chemoradiotherapy is a safe and effective treatment for patients with unresectable stage Ⅲ non-small cell lung cancer.
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Objective To evaluate the recent effects of concurrent versus sequential chemo-radio-therapy in treatment for locally advanced non-small-cell lung cancer (NSCLC). Methods The clinical data of 39 patients with locally advanced NSCLC were analyzed retrospectively. The sequential therapy was 23 (sequential group) ,and the concurrent therapy (concurrent group)was 16. The total radiation dose was 60 ～ 65 Gy by conventional fractionation radiotherapy. In sequential group,the patients received induction chemotherapy for two cycles followed by conventional radiation therapy. In concurrent group,the patients re-ceived radiation therapy,at the same time the docetaxe was given every week. Results The recent efficien-cy(62.5%) of concurrent therapy was higher than that(43.5% )of sequential therapy. The clinical remission rate of the two groups was similar. Conclusion Concurrent chemo-radiotherapy in locally advanced NSCLC can increase the recent effect. The concurrent treatment method of docetaxel + three-dimensional conformal radiotherapy is advocated.
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0.05).Conclusions:Concurrent chemoradiotherapy can be well tolerated even though the acute side-effects less than grade 2 were higher in concurrent chemoradiotherapy than other group.Immediate response was very encouraging in the concurrent group.There was no advantage in terms of survival rate in the concurrent group compared to the sequential group.