Involved-field irradiation concurrently combined with nedaplatin/5-fluorouracil for inoperable esophageal cancer on basis of (18)FDG-PET scans: a phase II study.

Abstract

PURPOSE:

A prospective study was performed on chemoradiotherapy (CRT) for esophageal cancer using involved-field radiation therapy (IFRT) based on 18-fluorodeoxyglucose positron-emission tomography. The goal of this phase II study was to evaluate the efficacy of the IFRT procedure in newly diagnosed esophageal cancer.

PATIENTS AND METHODS:

Eligible patients were adults with newly diagnosed untreated, inoperable esophageal cancer in stages I-IV with lymph node metastases. Patients received nedaplatin 80mg/m(2) per day on day 1, 5-fluorouracil 800mg/m(2) on days 1-4 intravenously repeated every 28days for 2-4 cycles, and combined IFRT. Elective nodal irradiation was not performed. Irradiation was applied only to the primary tumor and positive lymph nodes.

RESULTS:

From September 2009 to July 2012, of the 63 patients enrolled, 58 were evaluable for response. The primary end point of isolated out-of-field loco-regional nodal recurrence was seen in only two patients. The expectant rate was assumed to be less than 5%. The threshold value was set as 10% to calculate the number of registrations. Progression-free and overall survival rates at 36months were 47.7% and 51.1%, respectively. The median progression-free survival was 34.6months, and overall survival was 38.4months. Salvage surgery was tried for 11 patients (17.5%) due to residual or recurrent disease.

CONCLUSION:

The primary end point of the trial was demonstrated, indicating the efficacy of IFRT in the treatment of inoperable esophageal cancer mostly of squamous cell carcinoma.

• Authors: Hideomi Yamashita, Mami Omori, Ryousuke Takenaka, Kae Okuma, Reiko Kobayashi, Kuni Ohtomo, Keiichi Nakagawa
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 113 Issue 2 Pg. 182-7 (Nov 2014) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 25466372 (Publication Type: Clinical Trial, Phase II, Journal Article)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Organoplatinum Compounds
• nedaplatin
• Fluorouracil

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carcinoma, Squamous Cell (diagnostic imaging, drug therapy, radiotherapy, therapy)
• Chemoradiotherapy
• Disease-Free Survival
• Esophageal Neoplasms (diagnostic imaging, drug therapy, radiotherapy, therapy)
• Esophageal Squamous Cell Carcinoma
• Female
• Fluorouracil (administration & dosage)
• Humans
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Recurrence, Local (diagnostic imaging, drug therapy, radiotherapy, therapy)
• Organoplatinum Compounds (administration & dosage)
• Positron-Emission Tomography (methods)
• Prospective Studies
• Radiotherapy Planning, Computer-Assisted (methods)
• Survival Rate