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01.08.2009 | Original Article

Is a change in patient-reported dysphagia after induction chemotherapy in locally advanced esophageal cancer a predictive factor for pathological response to neoadjuvant chemoradiation?

verfasst von: Karin Ribi, Dieter Koeberle, Jan C. Schuller, Hanspeter Honegger, Arnaud Roth, Viviane Hess, Peter Moosmann, Roger von Moos, Markus Borner, Norbert Lombriser, Bernhard Pestalozzi, Thomas Ruhstaller

Erschienen in: Supportive Care in Cancer | Ausgabe 8/2009

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Abstract

Goals of work

In patients with locally advanced esophageal cancer, only those responding to the treatment ultimately benefit from preoperative chemoradiation. We investigated whether changes in subjective dysphagia or eating restrictions after two cycles of induction chemotherapy can predict histopathological tumor response observed after chemoradiation. In addition, we examined general long-term quality of life (QoL) and, in particular, eating restrictions after esophagectomy.

Materials and methods

Patients with resectable, locally advanced squamous cell- or adenocarcinoma of the esophagus were treated with two cycles of chemotherapy followed by chemoradiation and surgery. They were asked to complete the EORTC oesophageal-specific QoL module (EORTC QLQ-OES24), and linear analogue self-assessment QoL indicators, before and during neoadjuvant therapy and quarterly until 1 year postoperatively. A median change of at least eight points was considered as clinically meaningful.

Main results

Clinically meaningful improvements in the median scores for dysphagia and eating restrictions were found during induction chemotherapy. These improvements were not associated with a histopathological response observed after chemoradiation, but enhanced treatment compliance. Postoperatively, dysphagia scores remained low at 1 year, while eating restrictions persisted more frequently in patients with extended transthoracic resection compared to those with limited transhiatal resection.

Conclusions

The improvement of dysphagia and eating restrictions after induction chemotherapy did not predict tumor response observed after chemoradiation. One year after esophagectomy, dysphagia was a minor problem, and global QoL was rather good. Eating restrictions persisted depending on the surgical technique used.

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Titel: Is a change in patient-reported dysphagia after induction chemotherapy in locally advanced esophageal cancer a predictive factor for pathological response to neoadjuvant chemoradiation?
verfasst von: Karin Ribi
Dieter Koeberle
Jan C. Schuller
Hanspeter Honegger
Arnaud Roth
Viviane Hess
Peter Moosmann
Roger von Moos
Markus Borner
Norbert Lombriser
Bernhard Pestalozzi
Thomas Ruhstaller
Publikationsdatum: 01.08.2009
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 8/2009
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-008-0570-6

Springer Medizin

Is a change in patient-reported dysphagia after induction chemotherapy in locally advanced esophageal cancer a predictive factor for pathological response to neoadjuvant chemoradiation?