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18.01.2018 | Original Article

Neoadjuvant chemoradiation for esophageal cancer

Surgery improves locoregional control while response based on FDG-PET/CT predicts survival

verfasst von: Dr. med. Nina-Sophie Hegemann, Rebecca Koepple, Dr. med. Franziska Walter, David Boeckle, Dr. med. Wolfgang P. Fendler, Prof. Dr. med. Martin Kurt Angele, Prof. Dr. med. Stefan Boeck, Prof. Dr. med. Claus Belka, PD Dr. med. Falk Roeder

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 5/2018

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Abstract

Introduction

To retrospectively analyze the outcome of patients with esophageal cancer treated with neoadjuvant chemoradiation.

Methods

A total of 41 patients received neoadjuvant intent chemoradiation for esophageal cancer. Most patients had a locally advanced disease (T3/4: 82%, N+: 83%, M0: 100%) and squamous cell carcinoma (83%). All patients received concurrent chemotherapy with cisplatin/5-fluorouracil or mitomycin/5-fluorouracil. Median radiation dose was 50.4 Gy in the 25 patients who proceeded to surgery and 57.4 Gy in 16 patients who did not undergo surgery. FDG-PET/CT was used for treatment planning in 24 patients. A second FDG-PET/CT was available for response evaluation in 18 patients.

Results

Median follow-up was 16 months in all patients and 30 months in survivors. Radiotherapy was completed without interruptions >3 days in 90% of patients, and chemotherapy was carried out to >80% in 85% of patients. The 2‑year locoregional control rate was 60%, distant control rate 54% and overall survival rate 50%. Hematological toxicity grade 3/4 was observed in 34%/10% of patients and non-hematological toxicity grade 3/4 in 46%/2% of patients. Perioperative 30-day mortality was 4%. Subgroup analyses revealed that surgery significantly improved locoregional control (74% vs. 39%, p = 0.034), but not the 2‑year survival rate (54% vs. 43%, p = 0.246). In contrast, response based on FDG-PET/CT prior and after chemoradiation significantly predicted improved overall survival (2-year overall survival 61% vs. 40%, p = 0.048).

Conclusion

Outcomes of our cohort were comparable to other series using similar treatments. Surgery significantly improved locoregional control but not survival. Response based on FDG-PET/CT predicted survival and might be used for treatment stratification.

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Titel: Neoadjuvant chemoradiation for esophageal cancer
Surgery improves locoregional control while response based on FDG-PET/CT predicts survival
verfasst von: Dr. med. Nina-Sophie Hegemann
Rebecca Koepple
Dr. med. Franziska Walter
David Boeckle
Dr. med. Wolfgang P. Fendler
Prof. Dr. med. Martin Kurt Angele
Prof. Dr. med. Stefan Boeck
Prof. Dr. med. Claus Belka
PD Dr. med. Falk Roeder
Publikationsdatum: 18.01.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 5/2018
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-018-1261-y

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24.04.2024 | DGIM 2024 | Nachrichten

Springer Medizin

Neoadjuvant chemoradiation for esophageal cancer

Surgery improves locoregional control while response based on FDG-PET/CT predicts survival

Abstract

Introduction

Methods

Results

Conclusion

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Springer Medizin

Abstract

Introduction

Methods

Results

Conclusion

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