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Published in: Japanese Journal of Radiology 4/2019

01-04-2019 | Endoscopy | Original Article

Treatment outcomes according to the macroscopic tumor type in locally advanced esophageal squamous cell carcinoma treated by chemoradiotherapy

Authors: Katsumaro Kubo, Koichi Wadasaki, Katsunori Shinozaki

Published in: Japanese Journal of Radiology | Issue 4/2019

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Abstract

Purpose

To identify predictive factors for local control of locally advanced esophageal cancer by chemoradiotherapy, the relationship between clinical features, including macroscopic tumor type, and treatment outcome was analyzed in 83 patients.

Materials and methods

Macroscopic tumor type was defined by endoscopy as follows: type 1: protruding type; type 2: ulcerative and localized type; type 3: ulcerative and infiltrative type; type 4: diffusely infiltrative type; and type 5: unclassifiable type. We analyzed the overall survival, cause-specific survival, local progression-free rate, and predictive factors for locally advanced esophageal cancer after chemoradiotherapy.

Results

The median follow-up period at the time of evaluation was 59 months among survivors. The 5-year overall survival, cause-specific survival, and local progression-free rates for type 1 and other types were 37.0% and 23.3% (P = 0.4255), 71.8% and 30.3% (P = 0.0325), and 100% and 63.3% (P = 0.0246), respectively. Macroscopic tumor type (type 1) was the most significant predictive factor of cause-specific survival and local progression-free rates.

Conclusions

Macroscopic tumor type 1 was the significant favorable predictive factor for local control. The study results suggested that the macroscopic tumor type was useful in predicting tumor responses.
Literature
2.
go back to reference Ozawa S, Tachimori Y, Baba H, Matsubara H, Muro K, Numasaki H, et al. Comprehensive registry of esophageal cancer in Japan, 2002. Esophagus. 2010;7:7–22.CrossRef Ozawa S, Tachimori Y, Baba H, Matsubara H, Muro K, Numasaki H, et al. Comprehensive registry of esophageal cancer in Japan, 2002. Esophagus. 2010;7:7–22.CrossRef
3.
go back to reference Murakami M, Kuroda Y, Nakajima T, Okamoto Y, Mizowaki T, Kusumi F, et al. Comparison between chemoradiation protocol intended for organ preservation and conventional surgery for clinical T1–T2 esophageal carcinoma. Int J Radiat Oncol Biol Phys. 1999;45:277–84.CrossRefPubMed Murakami M, Kuroda Y, Nakajima T, Okamoto Y, Mizowaki T, Kusumi F, et al. Comparison between chemoradiation protocol intended for organ preservation and conventional surgery for clinical T1–T2 esophageal carcinoma. Int J Radiat Oncol Biol Phys. 1999;45:277–84.CrossRefPubMed
4.
go back to reference Hironaka S, Ohtsu A, Boku N, Muto M, Nagashima F, Saito H, et al. Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T (2–3) N (any) M (0) squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2003;57:425–33.CrossRefPubMed Hironaka S, Ohtsu A, Boku N, Muto M, Nagashima F, Saito H, et al. Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T (2–3) N (any) M (0) squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2003;57:425–33.CrossRefPubMed
5.
go back to reference Ohtsu A, Boku N, Muro K, Chin K, Muto M, Yoshida S, et al. Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol. 1999;17:2915–21.CrossRefPubMed Ohtsu A, Boku N, Muro K, Chin K, Muto M, Yoshida S, et al. Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol. 1999;17:2915–21.CrossRefPubMed
6.
go back to reference Nishimura Y, Suzuki M, Nakamatsu K, Kanamori S, Yagyu Y, Shigeoka H. Prospective trial of concurrent chemoradiotherapy with protracted infusion of 5-fluorouracil and cisplatin for T4 esophageal cancer with or without fistula. Int J Radiat Oncol Biol Phys. 2002;53:134–9.CrossRefPubMed Nishimura Y, Suzuki M, Nakamatsu K, Kanamori S, Yagyu Y, Shigeoka H. Prospective trial of concurrent chemoradiotherapy with protracted infusion of 5-fluorouracil and cisplatin for T4 esophageal cancer with or without fistula. Int J Radiat Oncol Biol Phys. 2002;53:134–9.CrossRefPubMed
7.
go back to reference Ishida K, Ando N, Yamamoto S, Ide H, Shioda M. Phase II study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group (JEOG) /Japan Clinical Oncology Group trial (JCOG9516). Jpn J Clin Oncol. 2004;34:615–9.CrossRefPubMed Ishida K, Ando N, Yamamoto S, Ide H, Shioda M. Phase II study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group (JEOG) /Japan Clinical Oncology Group trial (JCOG9516). Jpn J Clin Oncol. 2004;34:615–9.CrossRefPubMed
8.
go back to reference Wong RK, Malthaner RA, Zuraw L, Rumble RB. Combined modality radiotherapy and chemotherapy in nonsurgical management of localized carcinoma of the esophagus: a practice guideline. Int J Radiat Oncol Biol Phys. 2003;55:930–42.CrossRefPubMed Wong RK, Malthaner RA, Zuraw L, Rumble RB. Combined modality radiotherapy and chemotherapy in nonsurgical management of localized carcinoma of the esophagus: a practice guideline. Int J Radiat Oncol Biol Phys. 2003;55:930–42.CrossRefPubMed
9.
go back to reference Kato K, Muro K, Minashi K, Ohtsu A, Ishikura S, Boku N, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for stage II-III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81:684–90.CrossRefPubMed Kato K, Muro K, Minashi K, Ohtsu A, Ishikura S, Boku N, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for stage II-III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81:684–90.CrossRefPubMed
10.
go back to reference Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluoroiracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG 9907). Ann Surg Oncol. 2012;19:68–74.CrossRefPubMed Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluoroiracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG 9907). Ann Surg Oncol. 2012;19:68–74.CrossRefPubMed
11.
go back to reference Amini A, Ajani J, Komaki R, Allen PK, Minsky BD, Blum M, et al. Factors associated with local-regional failure after definitive chemoradiation for locally advanced esophageal cancer. Ann Surg Oncol. 2014;21:306–14.CrossRefPubMed Amini A, Ajani J, Komaki R, Allen PK, Minsky BD, Blum M, et al. Factors associated with local-regional failure after definitive chemoradiation for locally advanced esophageal cancer. Ann Surg Oncol. 2014;21:306–14.CrossRefPubMed
12.
go back to reference Kim HW, Kim JH, Lee IJ, Kim JW, Lee YC, Lee CG, et al. Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation. Digestion. 2014;90:254–60.CrossRefPubMed Kim HW, Kim JH, Lee IJ, Kim JW, Lee YC, Lee CG, et al. Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation. Digestion. 2014;90:254–60.CrossRefPubMed
13.
go back to reference Haefner MF, Lang K, Krung D, Koerber SA, Uhlmann L, Kieser M, et al. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy. J Radiat Res. 2015;56:742–9.CrossRefPubMedPubMedCentral Haefner MF, Lang K, Krung D, Koerber SA, Uhlmann L, Kieser M, et al. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy. J Radiat Res. 2015;56:742–9.CrossRefPubMedPubMedCentral
14.
go back to reference Chen Y, Zhang Z, Jiang G, Zhao K. Grass tumor volume is the prognostic factor for squamous cell esophageal cancer patients treated with definitive radiotherapy. J Thorac Dis. 2016;8:1155–61.CrossRefPubMedPubMedCentral Chen Y, Zhang Z, Jiang G, Zhao K. Grass tumor volume is the prognostic factor for squamous cell esophageal cancer patients treated with definitive radiotherapy. J Thorac Dis. 2016;8:1155–61.CrossRefPubMedPubMedCentral
15.
go back to reference Luo Y, Mao Q, Wang X, Yu J, Li M. Radiotherapy for esophageal carcinoma: dose, response and survival. Cancer Manag Res. 2018;10:13–211.CrossRefPubMed Luo Y, Mao Q, Wang X, Yu J, Li M. Radiotherapy for esophageal carcinoma: dose, response and survival. Cancer Manag Res. 2018;10:13–211.CrossRefPubMed
16.
go back to reference Sakanaka K, Ishida Y, Fujii K, Itasaka S, Miyamoto S, Horimatsu T, et al. Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma. Radiat Oncol. 2018;13:7.CrossRefPubMedPubMedCentral Sakanaka K, Ishida Y, Fujii K, Itasaka S, Miyamoto S, Horimatsu T, et al. Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma. Radiat Oncol. 2018;13:7.CrossRefPubMedPubMedCentral
17.
go back to reference Japan Esophageal Society. Japanese classification of esophageal cancer, 11th edition: part II and III. Esophagus. 2017;14:37–65.CrossRef Japan Esophageal Society. Japanese classification of esophageal cancer, 11th edition: part II and III. Esophagus. 2017;14:37–65.CrossRef
18.
go back to reference Murakami Y, Hamai Y, Emi M, Hihara J, Imano N, Takeuchi Y, et al. Long-term results of neoadjuvant chemoradiotherapy using cisplatin and 5-fluorouracil followed by esophagectomy for resectable, locally advanced esophageal squamous cell carcinoma. J Radiat Res. 2018;59:616–24.CrossRefPubMedPubMedCentral Murakami Y, Hamai Y, Emi M, Hihara J, Imano N, Takeuchi Y, et al. Long-term results of neoadjuvant chemoradiotherapy using cisplatin and 5-fluorouracil followed by esophagectomy for resectable, locally advanced esophageal squamous cell carcinoma. J Radiat Res. 2018;59:616–24.CrossRefPubMedPubMedCentral
19.
go back to reference Versteijine E, van Laarhoven HW, van Hooft JE, van Os RM, Geijsen ED, van Berge Henegouwen MI, et al. Definitive chemoradiation for patients with inoperable and/or unresectable esophageal cancer: locoregional recurrence pattern. Dis Esophagus. 2015;28:453–9.CrossRef Versteijine E, van Laarhoven HW, van Hooft JE, van Os RM, Geijsen ED, van Berge Henegouwen MI, et al. Definitive chemoradiation for patients with inoperable and/or unresectable esophageal cancer: locoregional recurrence pattern. Dis Esophagus. 2015;28:453–9.CrossRef
20.
go back to reference Shen WB, Zhu SC, Gao HM, Li YM, Su JW, Li J, et al. Analysis of failure patterns in patients with resectable esophageal squamous cell carcinoma receiving chemoradiotherapy. J Cancer Res Ther. 2016;12:62–8.CrossRefPubMed Shen WB, Zhu SC, Gao HM, Li YM, Su JW, Li J, et al. Analysis of failure patterns in patients with resectable esophageal squamous cell carcinoma receiving chemoradiotherapy. J Cancer Res Ther. 2016;12:62–8.CrossRefPubMed
21.
go back to reference Morita K, Takagi I, Watanabe M, Niwa K, Kanazawa H. Relationship between the radiologic features of esophageal cancer and the local control by radiation therapy. Cancer. 1985;55:2668–766.CrossRefPubMed Morita K, Takagi I, Watanabe M, Niwa K, Kanazawa H. Relationship between the radiologic features of esophageal cancer and the local control by radiation therapy. Cancer. 1985;55:2668–766.CrossRefPubMed
Metadata
Title
Treatment outcomes according to the macroscopic tumor type in locally advanced esophageal squamous cell carcinoma treated by chemoradiotherapy
Authors
Katsumaro Kubo
Koichi Wadasaki
Katsunori Shinozaki
Publication date
01-04-2019
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 4/2019
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-019-00814-6

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