Concurrent Selective Lymph Node Radiotherapy and S-1 Plus Cisplatin for Esophageal Squamous Cell Carcinoma: A Phase II Study

Journal Article · Sat Jun 15 04:00:00 EDT 2019 · Annals of Surgical Oncology (Online)

DOI:https://doi.org/10.1245/S10434-019-07264-4· OSTI ID:22927746

Wang, Xintong; Liu, Xiaomeng ^[1]; Li, Dakun ^[2]; Wang, Xinlei ^[3]; Huang, Wei; Li, Baosheng ^[1]

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1. Shandong Cancer Hospital Affiliated to Shandong University, Shandong University, Department of Radiation Oncology (China)
2. JiMo People’s Hospital, Department of Thoracic Surgery (China)
3. Qingdao Hiser Medical Center, Department of Gastroenterology (China)

Background: The efficacy, toxicity, and patterns of failure of esophageal squamous cell carcinoma (ESCC) treated with selective lymph node (SLN) conventional fraction radiotherapy (CFRT) and S-1 plus cisplatin (CDDP) were evaluated. Patients and Methods: 67 Patients with clinical stage II–IVa ESCC were enrolled. The total dose of SLN CFRT was 60 Gy in 30 fractions over 6 weeks. The first course of radiation covered the primary and metastatic regional tumors and high-risk lymph nodal regions, given at 2 Gy/fraction for a dose of 40 Gy. In the second course, CFRT was delivered to the boost volume for an additional 20 Gy in 10 days, using 2 Gy/fraction. Two cycles of chemotherapy were given at the beginning of radiotherapy. CDDP at 25 mg/m{sup 2}/day was given on days 1–3 and days 22–24, and S-1 at 80 mg/m{sup 2}/day on days 1–14 and days 22–35. Patients achieving objective response after concurrent chemoradiotherapy underwent two additional cycles of chemotherapy. Results: The objective response rate (ORR) was 82.5%. Grade 3 or 4 toxicities included leukopenia (23.8%), neutropenia (14.3%), thrombocytopenia (14.3%), hemoglobin (4.8%), gastrointestinal (12.7%), skin (1.6%), and esophagus fistula (1.6%). One patient died of severe pneumonia, and two died of late toxicity because of esophagus fistula. With median follow-up of 32 months, the overall survival (OS) and progression-free survival (PFS) at 1 year and 2 years were 81.0% and 73.0%, and 63.5% and 49.2%, respectively. Conclusions: SLN RT concurrent with S-1 plus CDDP may represent a better strategy for treatment of ESCC patients.

• OSTI ID: 22927746
• Journal Information: Annals of Surgical Oncology (Online), Journal Name: Annals of Surgical Oncology (Online) Journal Issue: 6 Vol. 26; ISSN 1534-4681
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
CHEMOTHERAPY
COMBINED THERAPY
ESOPHAGUS
HEMOGLOBIN
LEUKOPENIA
LYMPH NODES
METASTASES
PATIENTS
PNEUMONIA
RADIOTHERAPY
SKIN
TOXICITY