Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2018

Open Access 01-12-2018 | Research

Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma

Authors: Katsuyuki Sakanaka, Yuichi Ishida, Kota Fujii, Satoshi Itasaka, Shin’ichi Miyamoto, Takahiro Horimatsu, Manabu Muto, Takashi Mizowaki

Published in: Radiation Oncology | Issue 1/2018

Login to get access

Abstract

Background

The aim of this study was to identify the long-term clinical outcome of definitive radiotherapy using three-dimensional conformal radiotherapy (3DCRT) for cervical esophageal squamous cell carcinoma (CESCC).

Methods

We retrospectively reviewed the medical records of 30 patients with CESCC [clinical stage I/II/III/IV(M1LYM); 3/2/12/13] (TNM 7th edition) who underwent definitive radiotherapy using 3DCRT between 2000 and 2014 in our institution. The median prescribed dose for the gross tumor and metastatic lymph nodes was 60 Gy. Twenty-six patients underwent elective nodal irradiation for the neck node levels III, IV, and VI and for upper mediastinal lymph nodes with a median dose of 40 Gy. Twenty-six patients underwent concurrent chemotherapy. Initial disease progression sites, locoregional control (LRC) rate, overall survival (OS) rate, and toxicities were retrospectively evaluated. A univariate analysis was performed to identify prognostic factors.

Results

With a median follow-up of 110 months, the 5- and 10-year LRC rates were 43.7% and 37.4%, respectively. The 5- and 10-year OS rates were 48.3% and 40.2%, respectively. Locoregional, distant and both area accounted for 83%, 6% and 11% of the initial progression sites. Unresectable status and M1LYM were significantly associated with poor LRC (p < 0.05) and OS (p < 0.05). Grade 3 acute non-hematological toxicity occurred in 13.3% of patients. During the follow-up, patients without any disease progression did not need a permanent gastrostomy tube or tracheostomy. Late toxicity events, including hypothyroidism and cardiovascular disease, were observed; 5- and 10-year cumulative incidence rates of grade 2 hypothyroidism and ≥grade 3 cardiovascular disease were 31.6% and 62.5%, and 17.5% and 21.3%, respectively.

Conclusions

Definitive radiotherapy yields a cure for patients with CESCC while preserving their laryngopharyngeal function. The poor LRC rate in the advanced stage needs to be overcome for a better prognosis. As the incidence of radiation-induced hypothyroidism and cardiovascular disease was not low, long-term survivors should be followed up for these symptoms.
Literature
1.
Burmeister BH, Dickie G, Smithers BM, Hodge R, Morton K. Thirty-four patients with carcinoma of the cervical esophagus treated with chemoradiation therapy. Arch Otolaryngol Head Neck Surg. 2000;126:205–8.CrossRefPubMed
2.
Yamada K, Murakami M, Okamoto Y, Okuno Y, Nakajima T, Kusumi F, et al. Treatment results of radiotherapy for carcinoma of the cervical esophagus. Acta Oncol. 2006;45:1120–5.CrossRefPubMed
3.
Gkika E, Gauler T, Eberhardt W, Stahl M, Stuschke M, Pottgen C. Long-term results of definitive radiochemotherapy in locally advanced cancers of the cervical esophagus. Dis Esophagus. 2014;27:678–84.CrossRefPubMed
4.
Zenda S, Kojima T, Kato K, Izumi S, Ozawa T, Kiyota N, et al. Multicenter phase 2 study of cisplatin and 5-fluorouracil with concurrent radiation therapy as an organ preservation approach in patients with squamous cell carcinoma of the cervical esophagus. Int J Radiat Oncol Biol Phys. 2016;96:976–84.CrossRefPubMed
5.
Takebayashi K, Tsubosa Y, Matsuda S, Kawamorita K, Niihara M, Tsushima T, et al. Comparison of curative surgery and definitive chemoradiotherapy as initial treatment for patients with cervical esophageal cancer. Dis Esophagus. 2017;30:1–5.
6.
Huang SH, Lockwood G, Brierley J, Cummings B, Kim J, Wong R, et al. Effect of concurrent high-dose cisplatin chemotherapy and conformal radiotherapy on cervical esophageal cancer survival. Int J Radiat Oncol Biol Phys. 2008;71:735–40.CrossRefPubMed
7.
Zhang P, Xi M, Zhao L, Qiu B, Liu H, Hu YH, et al. Clinical efficacy and failure pattern in patients with cervical esophageal cancer treated with definitive chemoradiotherapy. Radiother Oncol. 2015;116:257–61.CrossRefPubMed
8.
Yang H, Feng C, Cai BN, Yang J, Liu HX, Ma L. Comparison of three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, and volumetric-modulated arc therapy in the treatment of cervical esophageal carcinoma. Dis Esophagus. 2017;30:1–8.
9.
Mcdowell LJ, Huang SH, Xu W, Che J, RKS W, Brierley J, et al. Effect of intensity modulated radiation therapy with concurrent chemotherapy on survival for patients with cervical esophageal carcinoma. Int J Radiat Oncol Biol Phys. 2017;98:186–95.CrossRefPubMed
10.
Herrmann E, Mertineit N, De Bari B, Hoeng L, Caparotti F, Leiser D, et al. Outcome of proximal esophageal cancer after definitive combined chemo-radiation: a Swiss multicenter retrospective study. Radiat Oncol. 2017;12:97.CrossRefPubMedPubMedCentral
11.
Stuschke M, Stahl M, Wilke H, Walz MK, Oldenburg AR, Stuben G, et al. Induction chemotherapy followed by concurrent chemotherapy and high-dose radiotherapy for locally advanced squamous cell carcinoma of the cervical esophagus. Oncology. 1999;57:99–105.CrossRefPubMed
12.
Cao CN, Luo JW, Gao L, Xu GZ, Yi JL, Huang XD, et al. Primary radiotherapy compared with primary surgery in cervical esophageal cancer. JAMA Otolaryngol Head Neck Surg. 2014;140:918–26.CrossRefPubMed
13.
Cao CN, Luo JW, Gao L, Xu GZ, Yi JL, Huang XD, et al. Intensity-modulated radiotherapy for cervical esophageal squamous cell carcinoma: clinical outcomes and patterns of failure. Eur Arch Otorhinolaryngol. 2016;273:741–47.CrossRefPubMed
14.
Daiko H, Hayashi R, Saikawa M, Sakuraba M, Yamazaki M, Miyazaki M, et al. Surgical management of carcinoma of the cervical esophagus. J Surg Oncol. 2007;96:166–72.CrossRefPubMed
15.
Ott K, Lordick F, Molls M, Bartels H, Biemer E, Siewert JR. Limited resection and free jejunal graft interposition for squamous cell carcinoma of the cervical esophagus. Br J Surg. 2009;96:258–66.CrossRefPubMed
16.
Marmuse JP, Koka VN, Guedon C, Benhamou G. Surgical treatment of carcinoma of the proximal esophagus. Am J Surg. 1995;169:386–90.CrossRefPubMed
17.
Tong DK, Law S, Kwong DL, Wei WI, Ng RW, Wong KH. Current management of cervical esophageal cancer. World J Surg. 2011;35:600–7.CrossRefPubMed
18.
Ito H, Itasaka S, Sakanaka K, Araki N, Mizowaki T, Hiraoka M. Long-term complications of definitive chemoradiotherapy for esophageal cancer using the classical method. J Radiat Res. 2017;58:106–13.CrossRefPubMedPubMedCentral
19.
Ishikura S, Nihei K, Ohtsu A, Boku N, Hironaka S, Mera K, et al. Long-term toxicity after definitive chemoradiotherapy for squamous cell carcinoma of the thoracic esophagus. J Clin Oncol. 2003;21:2697–702.CrossRefPubMed
20.
Sakanaka K, Ishida Y, Itasaka S, Ezoe Y, Aoyama I, Miyamoto S, et al. Identification of a predictive factor for distant metastasis in esophageal squamous cell carcinoma after definitive chemoradiotherapy. Int J Clin Oncol. 2016;21:899–908.CrossRefPubMed
21.
Gregoire V, Ang K, Budach W, Grau C, Hamoir M, Langendijk JA, et al. Delineation of the neck node levels for head and neck tumors: a 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiother Oncol. 2014;110:172–81.CrossRefPubMed
22.
Nishimura Y, Mitsumori M, Hiraoka M, Koike R, Nakamatsu K, Kawamura M, et al. A randomized phase II study of cisplatin/5-FU concurrent chemoradiotherapy for esophageal cancer: short-term infusion versus protracted infusion chemotherapy (KROSG0101/JROSG021). Radiother Oncol. 2009;92:260–5.CrossRefPubMed
23.
Shinoda M, Ando N, Kato K, Ishikura S, Kato H, Tsubosa Y, et al. Randomized study of low-dose versus standard-dose chemoradiotherapy for unresectable esophageal squamous cell carcinoma (JCOG0303). Cancer Sci. 2015;106:407–12.CrossRefPubMedPubMedCentral
24.
Cooper JS, Guo MD, Herskovic A, Macdonald JS, Martenson JA, Al-Sarraf M, et al. Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation therapy oncology group. JAMA. 1999;281:1623–7.CrossRefPubMed
25.
Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013;48:452–8.CrossRefPubMed
26.
Fenkell L, Kaminsky I, Breen S, Huang S, Van Prooijen M, Ringash J. Dosimetric comparison of IMRT vs. 3D conformal radiotherapy in the treatment of cancer of the cervical esophagus. Radiother Oncol. 2008;89:287–91.CrossRefPubMed
27.
Ronjom MF, Brink C, Bentzen SM, Hegedus L, Overgaard J, Johansen J. Hypothyroidism after primary radiotherapy for head and neck squamous cell carcinoma: normal tissue complication probability modeling with latent time correction. Radiother Oncol. 2013;109:317–22.CrossRefPubMed
28.
Curigliano G, Cardinale D, Suter T, Plataniotis G, de Azambuja E, Sandri MT, et al. Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO clinical practice guidelines. Ann Oncol. 2012;23:vii155–66.CrossRefPubMed
29.
Okoye CC, Bucher J, Tatsuoka C, Parikh SA, Oliveira GH, Gibson MK, et al. Cardiovascular risk and prevention in patients with head and neck cancer treated with radiotherapy. Head Neck. 2017;39:527–32.CrossRefPubMed
Metadata
Title
Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma
Authors
Katsuyuki Sakanaka
Yuichi Ishida
Kota Fujii
Satoshi Itasaka
Shin’ichi Miyamoto
Takahiro Horimatsu
Manabu Muto
Takashi Mizowaki
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-018-0957-6

Other articles of this Issue 1/2018

Radiation Oncology 1/2018 Go to the issue

Research

Assessing the impact of choosing different deformable registration algorithms on cone-beam CT enhancement by histogram matching

Research

Survival benefit of re-irradiation in esophageal Cancer patients with Locoregional recurrence: a propensity score-matched analysis

Research

Does baseline [18F] FDG-PET/CT correlate with tumor staging, response after neoadjuvant chemoradiotherapy, and prognosis in patients with rectal cancer?

Research

Monte Carlo verification of radiotherapy treatments with CloudMC

Research

Influence of 68Ga-DOTATOC on sparing of normal tissue for radiation therapy of skull base meningioma: differential impact of photon and proton radiotherapy

Research

Side effects of CT-guided implantation of 125I seeds for recurrent malignant tumors of the head and neck assisted by 3D printing non co-planar template