Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent Chemoradiotherapy
Esophageal squamous cell carcinoma (ESCC) and head/neck squamous cell carcinoma (HNSCC) are very common cancers worldwide, and there is higher incidence of synchronous ESCC/NSCC in Taiwan. The aim of the current study was to investigate the efficacy of different chemotherapy regimens in patients wit...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2020-01-01
|
Series: | Journal of Clinical Medicine |
Subjects: | |
Online Access: | https://www.mdpi.com/2077-0383/9/1/197 |
id |
doaj-5dae7cc6e4ac4765865a6b0fb58032aa |
---|---|
record_format |
Article |
spelling |
doaj-5dae7cc6e4ac4765865a6b0fb58032aa2020-11-25T00:35:15ZengMDPI AGJournal of Clinical Medicine2077-03832020-01-019119710.3390/jcm9010197jcm9010197Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent ChemoradiotherapyYen-Hao Chen0Hung-I Lu1Chih-Yen Chien2Chien-Ming Lo3Yu-Ming Wang4Shang-Yu Chou5Shau-Hsuan Li6Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Thoracic & Cardiovascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanEsophageal squamous cell carcinoma (ESCC) and head/neck squamous cell carcinoma (HNSCC) are very common cancers worldwide, and there is higher incidence of synchronous ESCC/NSCC in Taiwan. The aim of the current study was to investigate the efficacy of different chemotherapy regimens in patients with locally advanced synchronous ESCC/HNSCC who received curative concurrent chemoradiotheapy (CCRT). A total of 75 patients were identified and assigned to one of two groups: 45 patients receiving cisplatin/5-fluorouracil (5-FU) regime in one group and 30 patients receiving a weekly cisplatin regime in the other. Overall survival (OS) was calculated from the date of diagnosis of the ESCC or HNSCC to the date of death from any cause or the most recent follow-up. Kaplan−Meier curves and log-rank tests were used to estimate OS and differences between the two groups, respectively. There was no significant difference in the analysis of OS between the cisplatin/5-FU and the weekly cisplatin groups. However, patients that interrupted their CCRT were found to have worse OS compared to those without interruptions (5.4 months versus 18.8 months, <i>p</i> = 0.002). In subgroup analysis, patients without interruptions of CCRT had a better OS than those with interruptions in the cisplatin/5-FU group (13.0 months versus 5.4 months, <i>p</i> = 0.041) as well as in the weekly cisplatin group (21.4 months versus 5.0 months, <i>p</i> = 0.017). Interruption of CCRT was the only independently poor prognostic factor of OS in the univariate and multivariate (hazard ratio 0.18, <i>p</i> < 0.001) analyses. Most interruption of CCRT resulted from adverse events (AEs) or serious AEs. Although there was no significant difference in the incidence of AEs between these two groups, lower incidence of adverse events was mentioned in the weekly cisplatin group. Our study suggests that interruption of CCRT is an independently poor prognostic factor of OS, and that completion of CCRT without interruption is more important than the choice of chemotherapeutic regimen for patients with synchronous ESCC/HNSCC.https://www.mdpi.com/2077-0383/9/1/197chemotherapysynchronoushead and neck canceresophageal cancerconcurrent chemoradiotherapy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yen-Hao Chen Hung-I Lu Chih-Yen Chien Chien-Ming Lo Yu-Ming Wang Shang-Yu Chou Shau-Hsuan Li |
spellingShingle |
Yen-Hao Chen Hung-I Lu Chih-Yen Chien Chien-Ming Lo Yu-Ming Wang Shang-Yu Chou Shau-Hsuan Li Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent Chemoradiotherapy Journal of Clinical Medicine chemotherapy synchronous head and neck cancer esophageal cancer concurrent chemoradiotherapy |
author_facet |
Yen-Hao Chen Hung-I Lu Chih-Yen Chien Chien-Ming Lo Yu-Ming Wang Shang-Yu Chou Shau-Hsuan Li |
author_sort |
Yen-Hao Chen |
title |
Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent Chemoradiotherapy |
title_short |
Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent Chemoradiotherapy |
title_full |
Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent Chemoradiotherapy |
title_fullStr |
Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent Chemoradiotherapy |
title_full_unstemmed |
Efficacy of Different Chemotherapy Regimens in Patients with Locally Advanced Synchronous Esophageal and Head/Neck Squamous Cell Carcinoma Receiving Curative Concurrent Chemoradiotherapy |
title_sort |
efficacy of different chemotherapy regimens in patients with locally advanced synchronous esophageal and head/neck squamous cell carcinoma receiving curative concurrent chemoradiotherapy |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-01-01 |
description |
Esophageal squamous cell carcinoma (ESCC) and head/neck squamous cell carcinoma (HNSCC) are very common cancers worldwide, and there is higher incidence of synchronous ESCC/NSCC in Taiwan. The aim of the current study was to investigate the efficacy of different chemotherapy regimens in patients with locally advanced synchronous ESCC/HNSCC who received curative concurrent chemoradiotheapy (CCRT). A total of 75 patients were identified and assigned to one of two groups: 45 patients receiving cisplatin/5-fluorouracil (5-FU) regime in one group and 30 patients receiving a weekly cisplatin regime in the other. Overall survival (OS) was calculated from the date of diagnosis of the ESCC or HNSCC to the date of death from any cause or the most recent follow-up. Kaplan−Meier curves and log-rank tests were used to estimate OS and differences between the two groups, respectively. There was no significant difference in the analysis of OS between the cisplatin/5-FU and the weekly cisplatin groups. However, patients that interrupted their CCRT were found to have worse OS compared to those without interruptions (5.4 months versus 18.8 months, <i>p</i> = 0.002). In subgroup analysis, patients without interruptions of CCRT had a better OS than those with interruptions in the cisplatin/5-FU group (13.0 months versus 5.4 months, <i>p</i> = 0.041) as well as in the weekly cisplatin group (21.4 months versus 5.0 months, <i>p</i> = 0.017). Interruption of CCRT was the only independently poor prognostic factor of OS in the univariate and multivariate (hazard ratio 0.18, <i>p</i> < 0.001) analyses. Most interruption of CCRT resulted from adverse events (AEs) or serious AEs. Although there was no significant difference in the incidence of AEs between these two groups, lower incidence of adverse events was mentioned in the weekly cisplatin group. Our study suggests that interruption of CCRT is an independently poor prognostic factor of OS, and that completion of CCRT without interruption is more important than the choice of chemotherapeutic regimen for patients with synchronous ESCC/HNSCC. |
topic |
chemotherapy synchronous head and neck cancer esophageal cancer concurrent chemoradiotherapy |
url |
https://www.mdpi.com/2077-0383/9/1/197 |
work_keys_str_mv |
AT yenhaochen efficacyofdifferentchemotherapyregimensinpatientswithlocallyadvancedsynchronousesophagealandheadnecksquamouscellcarcinomareceivingcurativeconcurrentchemoradiotherapy AT hungilu efficacyofdifferentchemotherapyregimensinpatientswithlocallyadvancedsynchronousesophagealandheadnecksquamouscellcarcinomareceivingcurativeconcurrentchemoradiotherapy AT chihyenchien efficacyofdifferentchemotherapyregimensinpatientswithlocallyadvancedsynchronousesophagealandheadnecksquamouscellcarcinomareceivingcurativeconcurrentchemoradiotherapy AT chienminglo efficacyofdifferentchemotherapyregimensinpatientswithlocallyadvancedsynchronousesophagealandheadnecksquamouscellcarcinomareceivingcurativeconcurrentchemoradiotherapy AT yumingwang efficacyofdifferentchemotherapyregimensinpatientswithlocallyadvancedsynchronousesophagealandheadnecksquamouscellcarcinomareceivingcurativeconcurrentchemoradiotherapy AT shangyuchou efficacyofdifferentchemotherapyregimensinpatientswithlocallyadvancedsynchronousesophagealandheadnecksquamouscellcarcinomareceivingcurativeconcurrentchemoradiotherapy AT shauhsuanli efficacyofdifferentchemotherapyregimensinpatientswithlocallyadvancedsynchronousesophagealandheadnecksquamouscellcarcinomareceivingcurativeconcurrentchemoradiotherapy |
_version_ |
1725309462871277568 |