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20.05.2016 | Original Research

Efficacy and Safety of Induction Chemotherapy in Esophageal Cancer with Airway Involvement

verfasst von: Vanita Noronha, Amit Joshi, Vijay M. Patil, Nilendu Purandare, Sabita Jiwnani, Sarbani Ghosh-Laskar, Dipti Nakti, Bhavesh Bandekar, Kumar Prabhash

Erschienen in: Journal of Gastrointestinal Cancer | Ausgabe 3/2016

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Abstract

Purpose

Esophageal cancer with tracheobronchial involvement (TBI) has a poor prognosis. Radical therapy carries the risk of inducing tracheoesophageal fistula (TEF) and treatment-related mortality. Induction chemotherapy followed by reassessment for radical therapy may decrease morbidity and improve outcome.

Methods

This is a retrospective analysis of esophageal cancer patients with TBI who received induction chemotherapy. Airway involvement was defined as bronchoscopic appearance of a bulge into the lumen, restricted or immobile mucosa, frank infiltration, TEF, or stridor, which was clinically due to airway obstruction from the esophageal lesion.

Results

Eighty-three patients were included over 5 years; 97.6 % had squamous histology. All patients received taxane and platinum combination induction chemotherapy; 90.5 % of patients received chemotherapy without dose delays, and 77.8 % patients did not require a dose reduction or modification. The 31.7 % patients had a clinically significant ≥grade 3 toxicity. The objective response rate was 67 % among the patients who underwent restaging scans following induction chemotherapy; 79.5 % of the patients could receive radical intent therapy, either concurrent chemoradiotherapy, or radiation alone, or surgery in one patient. The TEF complication rate was 6 % during the course of therapy. At a median follow-up of 28 months in surviving patients, the estimated median PFS was 8 months (95 % CI 5.5–10.5) and the estimated median OS was 17 months (95 % CI 5.6–28.4). Patients who received radical therapy had a significantly better PFS and OS, p = 0.000.

Conclusions

Induction chemotherapy may improve the outcome of patients with esophageal cancer involving the airway and may help select patients for curative treatment and lower the risk of TEF development.

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Titel: Efficacy and Safety of Induction Chemotherapy in Esophageal Cancer with Airway Involvement
verfasst von: Vanita Noronha
Amit Joshi
Vijay M. Patil
Nilendu Purandare
Sabita Jiwnani
Sarbani Ghosh-Laskar
Dipti Nakti
Bhavesh Bandekar
Kumar Prabhash
Publikationsdatum: 20.05.2016
Verlag: Springer US
Erschienen in: Journal of Gastrointestinal Cancer / Ausgabe 3/2016
Print ISSN: 1941-6628
Elektronische ISSN: 1941-6636
DOI: https://doi.org/10.1007/s12029-016-9830-8

Springer Medizin

Efficacy and Safety of Induction Chemotherapy in Esophageal Cancer with Airway Involvement