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Erschienen in: Annals of Surgical Oncology 6/2019

25.02.2019 | Thoracic Oncology

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

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

Erschienen in: Annals of Surgical Oncology | Ausgabe 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.
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Metadaten
Titel
Concurrent Selective Lymph Node Radiotherapy and S-1 Plus Cisplatin for Esophageal Squamous Cell Carcinoma: A Phase II Study
verfasst von
Xintong Wang, PhD
Xiaomeng Liu, PhD
Dakun Li, BS
Xinlei Wang, MSc
Wei Huang, PhD
Baosheng Li, PhD, MD
Publikationsdatum
25.02.2019
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 6/2019
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07264-4

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