Preoperative low-dose weekly cisplatin and continuous infusion fluorouracil plus hyperfractionated radiotherapy in stage II-III esophageal carcinoma
Clin. transl. oncol. (Print)
; 18(11): 1106-1113, nov. 2016. tab, graf
Artigo
em Inglês
| IBECS
| ID: ibc-156876
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
BACKGROUND:
The optimal regimen of preoperative chemoradiotherapy for resectable esophageal cancer has not been established. We evaluated accelerated hyperfractionated radiotherapy (RT) concurrent to low-dose weekly cisplatin and continuous infusion fluorouracil (LDCI-FU) followed by esophagectomy in patients with locally advanced squamous cell carcinoma (SCC) of the esophagus.METHODS:
Patients with clinical stage II or III SCC of the esophagus received cisplatin 30 mg/m2/week (days 1, 8, 15), LDCI-FU 300 mg/m2/day (days 1-21), and concomitant RT to a dose of 45 Gy (150 cGy/fraction, 2 fractions/day) on tumor and affected lymph nodes, followed by radical esophagectomy.RESULTS:
From 1997 to 2012, 64 patients were treated with this regimen. Twenty-four patients (37 %) had grade 3 esophagitis, 18 (28 %) of whom required hospitalization. The risk of hospitalization was reduced by placement of a jejunostomy tube before starting induction chemoradiotherapy. Six patients (9 %) had grade 3-4 neutropenia. Fifty-three patients (83 %) underwent esophageal resection and complete resection was achieved in 45 (70 %). The overall median survival was 28 months (95 % CI 20.4-35.6) and 5-year survival was 38 %. In the 18 patients attaining a pathological complete response, median survival was 132 months and 5-year survival was 72 %. Positron emission tomography standardized uptake values (PET SUVmax) post-chemoradiotherapy were associated with pathological response (p = 0.03) and survival (p = 0.04).CONCLUSIONS:
Intensive preoperative hyperfractionated RT concomitant to low-dose cisplatin and LDCI-FU is effective in patients with locally advanced SCC of the esophagus, with good pathological response and survival and manageable toxicities. Post-chemoradiotherapy PET SUV max shows promise as a potential prognostic factorRESUMEN
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Espanha
Base de dados:
IBECS
Assunto principal:
Prognóstico
/
Neoplasias Esofágicas
/
Carcinoma
/
Cisplatino
/
Período Pré-Operatório
/
Fluoruracila
Tipo de estudo:
Estudo prognóstico
Aspecto:
Preferência do paciente
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Clin. transl. oncol. (Print)
Ano de publicação:
2016
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Germans Trias i Pujol/Spain
/
Hospital Universitari de Bellvitge/Spain
/
Hospital de Mataró/Spain