The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative Chemoradiotherapy
Objective: For patients with esophageal squamous cell carcinoma, preoperative chemoradiotherapy followed by planned esophagectomy is used as a curative treatment modality. However, the impact of radiotherapy dose remains undefined. Method: A total of 141 patients with stage III esophageal squamous c...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-03-01
|
Series: | Current Oncology |
Subjects: | |
Online Access: | https://www.mdpi.com/1718-7729/28/2/129 |
id |
doaj-0312df27d07f491c86772b828b072768 |
---|---|
record_format |
Article |
spelling |
doaj-0312df27d07f491c86772b828b0727682021-09-20T10:10:40ZengMDPI AGCurrent Oncology1198-00521718-77292021-03-01281291354136510.3390/curroncol28020129The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative ChemoradiotherapyChien-Ming Lo0Yu-Ming Wang1Yen-Hao Chen2Fu-Min Fang3Shun-Chen Huang4Hung-I Lu5Shau-Hsuan Li6Department of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Colledge of Medicine, Kaohsiung 833401, TaiwanDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Colledge of Medicine, Kaohsiung 833401, TaiwanDepartment of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Colledge of Medicine, Kaohsiung 833401, TaiwanDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Colledge of Medicine, Kaohsiung 833401, TaiwanDepartment of Pathology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Colledge of Medicine, Kaohsiung 833401, TaiwanDepartment of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Colledge of Medicine, Kaohsiung 833401, TaiwanDepartment of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Colledge of Medicine, Kaohsiung 833401, TaiwanObjective: For patients with esophageal squamous cell carcinoma, preoperative chemoradiotherapy followed by planned esophagectomy is used as a curative treatment modality. However, the impact of radiotherapy dose remains undefined. Method: A total of 141 patients with stage III esophageal squamous cell carcinoma (ESCC; as defined by the 7th American Joint Committee on Cancer), receiving preoperative chemoradiotherapy followed by esophagectomy between 2000 and 2015 at Kaohsiung Chang Gung Memorial Hospital, Taiwan, were retrospectively reviewed. The radiotherapy dose of preoperative chemoradiotherapy (36 Gy before 2009 and 50–50.4 Gy after 2009) and other clinicopathological parameters were collected and correlated with the response to chemoradiotherapy and treatment outcome. Result: Of these 141 patients, the radiotherapy dose was 36 Gy in 59 (42%) patients and 50 Gy in 82 (58%) patients. A complete pathological response was noted in 12 (20%) of 59 patients receiving 36 Gy radiotherapy, and 37 (45%) of 82 patients receiving 50 Gy radiotherapy (<i>p</i> = 0.002). The three-year overall survival and disease-free survival rates were 31% and 25% in patients receiving 36 Gy radiotherapy, and 54% and 46% in patients receiving 50–50.4 Gy radiotherapy, respectively (<i>p</i> = 0.023 for overall survival; <i>p</i> = 0.047 for disease-free survival). Multivariate analysis showed that a higher radiotherapy dose was associated with increased pathological complete response (<i>p</i> = 0.003, hazard ratio: 3.215), better overall survival (<i>p</i> = 0.024, hazard ratio: 1.585), and superior disease-free survival (<i>p</i> = 0.049, hazard ratio: 1.493). However, higher radiotherapy doses revealed more surgical complications, including acute respiratory distress syndrome (<i>p</i> = 0.048) and anastomosis leaks (<i>p</i> = 0.004). Conclusion: For patients with locally advanced ESCC, preoperative chemoradiotherapy with higher radiotherapy doses led to increased pathologic complete response rates and improved survival.https://www.mdpi.com/1718-7729/28/2/129esophageal squamous cell carcinomachemoradiotherapyesophagectomyradiotherapy dose |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chien-Ming Lo Yu-Ming Wang Yen-Hao Chen Fu-Min Fang Shun-Chen Huang Hung-I Lu Shau-Hsuan Li |
spellingShingle |
Chien-Ming Lo Yu-Ming Wang Yen-Hao Chen Fu-Min Fang Shun-Chen Huang Hung-I Lu Shau-Hsuan Li The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative Chemoradiotherapy Current Oncology esophageal squamous cell carcinoma chemoradiotherapy esophagectomy radiotherapy dose |
author_facet |
Chien-Ming Lo Yu-Ming Wang Yen-Hao Chen Fu-Min Fang Shun-Chen Huang Hung-I Lu Shau-Hsuan Li |
author_sort |
Chien-Ming Lo |
title |
The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative Chemoradiotherapy |
title_short |
The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative Chemoradiotherapy |
title_full |
The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative Chemoradiotherapy |
title_fullStr |
The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative Chemoradiotherapy |
title_full_unstemmed |
The Impact of Radiotherapy Dose in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma Receiving Preoperative Chemoradiotherapy |
title_sort |
impact of radiotherapy dose in patients with locally advanced esophageal squamous cell carcinoma receiving preoperative chemoradiotherapy |
publisher |
MDPI AG |
series |
Current Oncology |
issn |
1198-0052 1718-7729 |
publishDate |
2021-03-01 |
description |
Objective: For patients with esophageal squamous cell carcinoma, preoperative chemoradiotherapy followed by planned esophagectomy is used as a curative treatment modality. However, the impact of radiotherapy dose remains undefined. Method: A total of 141 patients with stage III esophageal squamous cell carcinoma (ESCC; as defined by the 7th American Joint Committee on Cancer), receiving preoperative chemoradiotherapy followed by esophagectomy between 2000 and 2015 at Kaohsiung Chang Gung Memorial Hospital, Taiwan, were retrospectively reviewed. The radiotherapy dose of preoperative chemoradiotherapy (36 Gy before 2009 and 50–50.4 Gy after 2009) and other clinicopathological parameters were collected and correlated with the response to chemoradiotherapy and treatment outcome. Result: Of these 141 patients, the radiotherapy dose was 36 Gy in 59 (42%) patients and 50 Gy in 82 (58%) patients. A complete pathological response was noted in 12 (20%) of 59 patients receiving 36 Gy radiotherapy, and 37 (45%) of 82 patients receiving 50 Gy radiotherapy (<i>p</i> = 0.002). The three-year overall survival and disease-free survival rates were 31% and 25% in patients receiving 36 Gy radiotherapy, and 54% and 46% in patients receiving 50–50.4 Gy radiotherapy, respectively (<i>p</i> = 0.023 for overall survival; <i>p</i> = 0.047 for disease-free survival). Multivariate analysis showed that a higher radiotherapy dose was associated with increased pathological complete response (<i>p</i> = 0.003, hazard ratio: 3.215), better overall survival (<i>p</i> = 0.024, hazard ratio: 1.585), and superior disease-free survival (<i>p</i> = 0.049, hazard ratio: 1.493). However, higher radiotherapy doses revealed more surgical complications, including acute respiratory distress syndrome (<i>p</i> = 0.048) and anastomosis leaks (<i>p</i> = 0.004). Conclusion: For patients with locally advanced ESCC, preoperative chemoradiotherapy with higher radiotherapy doses led to increased pathologic complete response rates and improved survival. |
topic |
esophageal squamous cell carcinoma chemoradiotherapy esophagectomy radiotherapy dose |
url |
https://www.mdpi.com/1718-7729/28/2/129 |
work_keys_str_mv |
AT chienminglo theimpactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT yumingwang theimpactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT yenhaochen theimpactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT fuminfang theimpactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT shunchenhuang theimpactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT hungilu theimpactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT shauhsuanli theimpactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT chienminglo impactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT yumingwang impactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT yenhaochen impactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT fuminfang impactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT shunchenhuang impactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT hungilu impactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy AT shauhsuanli impactofradiotherapydoseinpatientswithlocallyadvancedesophagealsquamouscellcarcinomareceivingpreoperativechemoradiotherapy |
_version_ |
1717374559878905856 |