Top

Published in:

Open Access 01-12-2012 | Research article

Long-term bresults of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer: update on a phase II study

Authors: Keiichi Jingu, Haruo Matsushita, Ken Takeda, Rei Umezawa, Chiaki Takahashi, Toshiyuki Sugawara, Masaki Kubozono, Keiko Abe, Takaya Tanabe, Yuko Shirata, Takaya Yamamoto, Youjirou Ishikawa, Kenji Nemoto

Published in: BMC Cancer | Issue 1/2012

Abstract

Background

In 2006, we reported the effectiveness of chemoradiotherapy for postoperative recurrent esophageal cancer with a median observation period of 18 months. The purpose of the present study was to update the results of radiotherapy combined with nedaplatin and 5-fluorouracil (5-FU) for postoperative loco-regional recurrent esophageal cancer.

Methods

Between 2000 and 2004, we performed a phase II study on treatment of postoperative loco-regional recurrent esophageal cancer with radiotherapy (60 Gy/30 fractions/6 weeks) combined with chemotherapy consisting of two cycles of nedaplatin (70 mg/m²/2 h) and 5-FU (500 mg/m²/24 h for 5 days).

The primary endpoint was overall survival rate, and the secondary endpoints were progression-free survival rate, irradiated-field control rate and chronic toxicity.

Results

A total of 30 patients were enrolled in this study. The regimen was completed in 76.7% of the patients. The median observation period for survivors was 72.0 months. The 5-year overall survival rate was 27.0% with a median survival period of 21.0 months. The 5-year progression-free survival rate and irradiated-field control rate were 25.1% and 71.5%, respectively. Grade 3 or higher late toxicity was observed in only one patient. Two long-term survivors had gastric tube cancer more than 5 years after chemoradiotherapy.

Pretreatment performance status, pattern of recurrence (worse for patients with anastomotic recurrence) and number of recurrent lesions (worse for patients with multiple recurrent lesions) were statistically significant prognostic factors for overall survival.

Conclusions

Radiotherapy combined with nedaplatin and 5-FU is a safe and effective salvage treatment for postoperative loco-regional recurrent esophageal cancer. However, the prognosis of patients with multiple regional recurrence or anastomotic recurrence is very poor.

Available only for authorised users

Akiyama H, Tsurumaru M, Udagawa H, Kajiyama Y: Radical lymph node dissection for cancer of the thoracic esophagus. Ann Surg. 1994, 220: 364-373. 10.1097/00000658-199409000-00012.CrossRefPubMedPubMedCentral

Fujita H, Kakegawa T, Yamana H, Shima I, Toh Y, Tomita Y, Fujii T, Yamasaki K, Higaki K, Noake T, Ishibashi N, Mizutani K: Mortality and morbidity rates, postoperative course, quality of life, and prognosis after extended radical lymphadenectomy for esophageal cancer. Ann Surg. 1995, 222: 654-662. 10.1097/00000658-199511000-00008.CrossRefPubMedPubMedCentral

Nakagawa S, Kanda T, Kosugi S, Ohashi M, Suzuki T, Hatakeyama K: Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg. 2004, 198: 205-211. 10.1016/j.jamcollsurg.2003.10.005.CrossRefPubMed

Law SY, Fok M, Wong J: Pattern of recurrence after oesophageal resection for cancer: clinical implications. Br J Surg. 1996, 83: 107-111. 10.1002/bjs.1800830134.CrossRefPubMed

Bhansali MS, Fujita H, Kakegawa T, Yamana H, Ono T, Hikita S, Toh Y, Fujii T, Tou U, Shirouzu K: Pattern of recurrence after extended radical esophagectomy with three-field lymph node dissection for squamous cell carcinoma in the thoracic esophagus. World J Surg. 1997, 21: 275-281. 10.1007/s002689900228.CrossRefPubMed

Kato H, Miyazaki T, Nakajima M, Sohda M, Fukai Y, Masuda N, Fukuchi M, Manda R, Tsukada K, Kuwano H: Prediction of hematogenous recurrence in patients with esophageal carcinoma. Jpn J Thorac Cardiovasc Surg. 2003, 51: 599-608. 10.1007/BF02736700.CrossRefPubMed

Hulscher JB, van Sandick JW, Tijssen JG, Obertop H, van Lanschot JJ: The recurrence pattern of esophageal carcinoma after transhiatal resection. J Am Coll Surg. 2000, 191: 143-148. 10.1016/S1072-7515(00)00349-5.CrossRefPubMed

Kyriazanos ID, Tachibana M, Shibakita M, Yoshimaru H, Kinugasa S, Dhar DK, Nakamoto T, Fujii T, Nagasue N: Pattern of recurrence after extended esophagectomy for squamous cell carcinoma of the esophagus. Hepatogastroenterology. 2003, 50: 115-120.PubMed

Fahn HJ, Wang LS, Huang BS, Huang MH, Chien KY: Tumor recurrence in long-term survivors after treatment of carcinoma of the esophagus. Ann Thorac Surg. 1994, 57: 677-681. 10.1016/0003-4975(94)90566-5.CrossRefPubMed

10.

Jingu K, Nemoto K, Matsushita H, Takahashi C, Ogawa Y, Sugawara T, Nakata E, Takai Y, Yamada S: Results of radiation therapy combined with nedaplatin (cis-diammine-glycoplatinum) and 5-fluorouracil for postoperative locoregional recurrent esophageal cancer. BMC Cancer. 2006, 6: 50-10.1186/1471-2407-6-50.CrossRefPubMedPubMedCentral

11.

Nishimura Y, Koike R, Nakamatsu K, Kanamori S, Suzuki M, Shigeoka H, Shiozaki H: Concurrent chemoradiotherapy with protracted infusion of 5-FU and Cisplatin for postoperative recurrent or residual esophageal cancer. Jpn J Clin Oncol. 2003, 33: 341-345. 10.1093/jjco/hyg065.CrossRefPubMed

12.

Raoul JL, Le Prise E, Meunier B, Julienne V, Etienne PL, Gosselin M, Launois B: Combined radiochemotherapy for postoperative recurrence of oesophageal cancer. Gut. 1995, 37: 174-176. 10.1136/gut.37.2.174.CrossRefPubMedPubMedCentral

13.

Nemoto K, Ariga H, Kakuto Y, Matsushita H, Takeda K, Takahashi C, Takai Y, Yamada S, Hosoi Y: Radiation therapy for loco-regionally recurrent esophageal cancer after surgery. Radiother Oncol. 2001, 61: 165-168. 10.1016/S0167-8140(01)00392-9.CrossRefPubMed

14.

Shioyama Y, Nakamura K, Ohga S, Nomoto S, Sasaki T, Yamaguchi T, Toba T, Yoshitake T, Terashima H, Honda H: Radiation therapy for recurrent esophageal cancer after surgery: clinical results and prognostic factors. Jpn J Clin Oncol. 2007, 37: 918-923. 10.1093/jjco/hym138.CrossRefPubMed

15.

Maruyama K, Motoyama S, Anbai A, Usami S, Sato Y, Shibuya K, Yoshino K, Nakatsu T, Minamiya Y, Ogawa JI: Therapeutic strategy for the treatment of postoperative recurrence of esophageal squamous cell carcinoma: clinical efficacy of radiotherapy. Dis Esophagus. 2011, 24: 166-171. 10.1111/j.1442-2050.2010.01119.x.CrossRefPubMed

16.

Jingu K, Ariga H, Nemoto K, Narazaki K, Umezawa R, Takeda K, Koto M, Sugawara T, Kubozono M, Miyata G, Onodera K, Yamada S: Long-term results of radiochemotherapy for solitary lymph node metastasis after curative resection of esophageal cancer. Int J Radiat Oncol Biol Phys. 2012, 83: 172-177. 10.1016/j.ijrobp.2011.06.1978.CrossRefPubMed

17.

Niibe Y, Hayakawa K: Oligometastases and oligo-recurrence: the new era of cancer therapy. Jpn J Clin Oncol. 2010, 40: 107-111. 10.1093/jjco/hyp167.CrossRefPubMedPubMedCentral

18.

Iwata N, Kuniyasu K, Hirai T, Yamashita Y, Yoshimoto A, Kuwahara M, Toge T: Pathological study on the mucosal damage of gastric replacement of the esophagus after the postoperative radiation. J Jpn Surg Assoc. 1997, 58: 2784-2790. in Japanese with English abstract

19.

Lin FC, Russell H, Ferguson MK: Strangulation of the reconstructive gastric tube by the azygos arch. Ann Thorac Surg. 2006, 82: 8-10. 10.1016/j.athoracsur.2006.05.009.CrossRef

20.

Zhang J, Peng F, Li N, Liu Y, Xu Y, Zhou L, Wang J, Zhu J, Huang M, Gong Y: Salvage concurrent radio-chemotherapy for postoperative local recurrence of squamous-cell esophageal cancer. Radiat Oncol. 2012, 7 (1): 93-10.1186/1748-717X-7-93.CrossRefPubMedPubMedCentral

21.

Earlam R, Cunha-Melo JR: Oesophageal squamous cell carcinoma: i a critical review of surgery. Br J Surg. 1980, 67: 381-390. 10.1002/bjs.1800670602.CrossRefPubMed

22.

Sugiura T, Kato H, Tachimori Y, Igaki H, Yamaguchi H, Nakanishi Y: Second primary carcinoma in the gastric tube constructed as an esophageal substitute after esophagectomy. J Am Coll Surg. 2002, 194: 578-583. 10.1016/S1072-7515(02)01135-3.CrossRefPubMed

23.

Kise Y, Kijima H, Shimada H, Tanaka H, Kenmochi T, Chino O, Tajima T, Makuuchi H: Gastric tube cancer after esophagectomy for esophageal squamous cell cancer and its relevance to Helicobacter pylori. Hepatogastroenterology. 2003, 50: 408-411.PubMed

24.

Bamba T, Kosugi S, Takeuchi M, Kobayashi M, Kanda T, Matsuki A, Hatakeyama K: Surveillance and treatment for second primary cancer in the gastric tube after radical esophagectomy. Surg Endosc. 2010, 24: 1310-1317. 10.1007/s00464-009-0766-y.CrossRefPubMed

25.

Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, Taniyama K, Sasaki N, Schlemper RJ: Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001, 345: 784-789. 10.1056/NEJMoa001999.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/12/542/prepub

Title: Long-term bresults of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer: update on a phase II study
Authors: Keiichi Jingu
Haruo Matsushita
Ken Takeda
Rei Umezawa
Chiaki Takahashi
Toshiyuki Sugawara
Masaki Kubozono
Keiko Abe
Takaya Tanabe
Yuko Shirata
Takaya Yamamoto
Youjirou Ishikawa
Kenji Nemoto
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: BMC Cancer / Issue 1/2012
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/1471-2407-12-542

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2012

Pancreatic cancer circulating tumour cells express a cell motility gene signature that predicts survival after surgery

Bax expression measured by AQUAnalysis is an independent prognostic marker in oral squamous cell carcinoma

The clinical significance of tumor infiltrating lymphoctyes in breast cancer: does subtype matter?

Development of coronary artery stenosis in a patient with metastatic renal cell carcinoma treated with sorafenib

Body mass index and survival after breast cancer diagnosis in Japanese women

A case–control study of occupation/industry and renal cell carcinoma risk

Keynote webinar | Spotlight on antibody–drug conjugates in cancer