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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2019

01-06-2019 | Esophageal Cancer | Thoracic Oncology

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

Authors: Xintong Wang, PhD, Xiaomeng Liu, PhD, Dakun Li, BS, Xinlei Wang, MSc, Wei Huang, PhD, Baosheng Li, PhD, MD

Published in: Annals of Surgical Oncology | Issue 6/2019

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Abstract

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/m2/day was given on days 1–3 and days 22–24, and S-1 at 80 mg/m2/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.
Literature
1.
Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016; 66(2):115–32.CrossRefPubMed
2.
Minsky BD, Pajak TF, Ginsberg RJ, et al. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol. 2002;20(5):1167–74.CrossRefPubMed
3.
Cooper JS, Guo MD, Herskovic A, 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(17):1623–7.PubMed
4.
Hirata K, Horikoshi N, Aiba K, et al. Pharmacokinetic study of S-1, a novel oral fluorouracil antitumor drug. Clin Cancer Res. 1999;5(8):2000–5.PubMed
5.
Iwase H, Shimada M, Tsuzuki T, et al. Concurrent chemoradiotherapy with a novel fluoropyrimidine, S-1, and cisplatin for locally advanced esophageal cancer: long-term results of a phase II trial. Oncology. 2013;84(6):342–9.CrossRefPubMed
6.
Cho SH, Shim HJ, Lee SR, et al. Concurrent chemoradiotherapy with S-1 and cisplatin in advanced esophageal cancer. Dis Esophagus. 2008;21(8): 697–703.CrossRefPubMed
7.
Li BS, Zhou T, Wang ZT, et al. Phase I study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and capecitabine, cisplatin for locally advanced esophageal squamous cell carcinoma. Radiother Oncol. 2009; 93(3):458–61.CrossRefPubMed
8.
Wang D, Yang J, Zhu J, et al. Elective lymph node irradiation late course accelerated hyper-fractionated radiotherapy plus concurrent cisplatin-based chemotherapy for esophageal squamous cell carcinoma: a phase II study. Radiat Oncol. 2013; 8(1):108.CrossRefPubMedCentralPubMed
9.
Li BS, Gong HY, Huang W, et al. Phase I study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and pemetrexed, cisplatin for locally advanced esophageal squamous cell carcinoma. Dis Esophagus. 2011; 24(4):251–7.CrossRefPubMed
10.
Li M, Fu C, Zhang W, et al. Phase I study of concurrent selective lymph node late-course accelerated hyperfractionated radiotherapy and S-1 plus cisplatin for locally advanced oesophageal squamous cell carcinoma. Br J Radiol. 2016;89(1060): 20150476.CrossRefPubMedCentralPubMed
11.
Akiyama H, Tsurumaru M, Udagawa H, et al. Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg Oncol. 1994; 220(3):364–73.CrossRef
12.
Natsugoe S, Matsumoto M, Okumura H, et al. Initial metastatic, including micrometastatic, sites of lymph nodes in esophageal squamous cell carcinoma. J Surg Oncol. 2005; 89(1):6–11.CrossRefPubMed
13.
Li H, Zhang Y, Cai H, et al. Pattern of lymph node metastases in patients with squamous cell carcinoma of the thoracic esophagus who underwent three-field lymphadenectomy. Eur Surg Res. 2007;39(1):1–6.CrossRefPubMed
14.
Isono K, Uchida Y, Watanabe H, et al. Guidelines for clinical and pathologic studies on carcinoma of the esophagus ninth edition. Preface general principles part I. Esophagus. 2004;1(2):61–88.
15.
Sai H, Mitsumori M, Yamauchi C, et al. Concurrent chemoradiotherapy for esophageal cancer: comparison between intermittent standard-dose cisplatin with 5-fluorouracil and daily low-dose cisplatin with continuous infusion of 5-fluorouracil. Int J Clin Oncol. 2004; 9(3):149–53.CrossRefPubMed
16.
Kato K, Muro K, Minashi K, 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(3):684–90.CrossRefPubMed
17.
Tahara M, Fuse N, Mizusawa J, et al. Phase I/II trial of chemoradiotherapy with concurrent S-1 and cisplatin for clinical stage II/III esophageal carcinoma (JCOG 0604). Cancer Sci. 2015;106(10):1414–20.CrossRefPubMedCentralPubMed
Metadata
Title
Concurrent Selective Lymph Node Radiotherapy and S-1 Plus Cisplatin for Esophageal Squamous Cell Carcinoma: A Phase II Study
Authors
Xintong Wang, PhD
Xiaomeng Liu, PhD
Dakun Li, BS
Xinlei Wang, MSc
Wei Huang, PhD
Baosheng Li, PhD, MD
Publication date
01-06-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07264-4

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