scholarly journals A Reliable Nomogram is Identified to Predict the Overall Survival for Patients With Local Advanced Esophageal Cancer After Radiation Therapy Combined With Chemotherapy Followed by Surgery

2019 ◽  
Vol 105 (1) ◽  
pp. E184
Author(s):  
B. Gao
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Advanced Esophageal Cancer ◽  
Local Advanced

scholarly journals Clinical Efficacy of HiPorfin Photodynamic Therapy for Advanced Obstructive Esophageal Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303382093033
Author(s):  
Ruifang Zeng ◽  
Chen Liu ◽  
Libo Li ◽  
Xiaojun Cai ◽  
Run Chen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Photodynamic Therapy ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Advanced Esophageal Cancer ◽  
Karnofsky Performance Status Score ◽  
Status Score ◽  
Performance Status Score

Objective: To explore the clinical efficacy of HiPorfin photodynamic therapy for advanced esophageal cancer and evaluate its impact on survival. Methods: Retrospective analysis of 32 patients with advanced obstructive esophageal cancer at our institution from September 2013 to December 2016. HiPorfin was infused as the photosensitizer at a dose of 5 mg/kg, and after 48 hours, 630-nm laser irradiation was subsequently performed through an optical fiber that passed through the biopsy channel of a flexible endoscope. Results: The effectiveness rate was 78.1% (25/32), and the significant efficacy rate was 56.3% (18/32). The dysphagia score decreased from 3.43 ± 0.73 to 1.79 ± 0.53 ( P < .05). There was no grade 3 or more toxicity. The median overall survival was estimated to be 16 months. Univariate analysis showed higher overall survival with a Karnofsky Performance Status score ≥80 compared with a Karnofsky Performance Status score <80 (hazard ratio: 2.626; 95% CI: 1.091-6.322; P = .024). Overall survival was higher in patients who had received radiation therapy than in patients who did not receive radiation therapy (hazard ratio: 3.574; 95% CI: 1.501-8.510; P = .002). Conclusion: Photodynamic therapy is an effective method for advanced esophageal cancer. The side effects are mild, and the short-term effect is good, especially in the relief of dysphagia. Photodynamic therapy can prolong the survival of patients with advanced esophageal cancer, and the Karnofsky Performance Status score and previous radiation therapy have a significant effect on the overall survival.

PS02.138: SALVAGE ESOPHAGECTOMY: SINGLE ONCOLOGICAL CENTER EXPERIENCE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 159-160
Author(s):  
Flávio Sabino ◽  
Marco Guimaraes ◽  
Carlos Eduardo Pinto ◽  
Daniel Fernandes ◽  
Luis Felipe Pinto ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Conflicts Of Interest ◽  
High Volume ◽  
Published Data ◽  
Surgical Morbidity ◽  
Salvage Esophagectomy ◽  
Thoracic Approach ◽  
Clinical Conditions ◽  
Local Advanced

Abstract Background Surgical resection is considering the gold standard in esophageal cancer treatment, with 15–40% cure global rates. Radical exclusive chemoradiotherapy (CRT) is used in patients with local advanced esophageal cancer or without clinical conditions for esophagectomy, with a 5-year overall survival up to 30%. However, locoregional control is poor with a 40–60% recurrence rate and salvage esophagectomy maybe an option for these patients. Methods Our objective is to report the experience of a single high volume oncological institution with salvage esophagectomy. Retrospective analysis of 28 patients medical records, with esophageal cancer, submitted to Salvage Esophagectomy in Brazilian NCI after radical exclusive CRT or RT between January 1990 and December 2015. Results Median age was 56 years and most are male (78,5%). Esophageal middle third was the tumor principal location (50%) and histological type was squamous cell carcinoma (82%). Thoracic approach for esophagectomy was the principal surgical technique, and gastric tube the most used conduit for reconstruction (78,5%). Surgery was R0 in 83% of the cases, with a surgical morbidity of 64%. Median hospital time was 15 days (8–58) and surgical mortality 14% (4 patients), with 7% in the first 30 days. Median overall survival was 22,3 months. Conclusion Our results are in line with published data in the literature. Besides surgical morbidity and mortality, Salvage Esophagectomy remains de only chance of cure for patients with locoregional recurrence after radical exclusive CRT. Disclosure All authors have declared no conflicts of interest.

Phase II cisplatin, irinotecan, cetuximab and concurrent radiation therapy followed by surgery for locally advanced esophageal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4064-4064 ◽  
Author(s):  
P. C. Enzinger ◽  
T. Yock ◽  
W. Suh ◽  
P. Fidias ◽  
H. Mamon ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Phase Ii ◽  
Locally Advanced ◽  
Complete Response ◽  
Tumor Location ◽  
Advanced Esophageal Cancer ◽  
Early Results ◽  
Ecog Ps ◽  
Locally Advanced Esophageal Cancer

4064 Background: Weekly irinotecan, cisplatin, and concurrent radiation therapy is a well-tolerated, active regimen in locally advanced esophageal cancer. (Ilson. JCO 2003) Cetuximab, an EGFR inhibitor, is a potent radiation sensitizer in head and neck cancer. (Bonner. Proc ASCO 2004) Methods: In this phase II trial, patients (pts) with T2–4N0–1M0–1A esophageal adenocarcinoma (A) or squamous cell carcinoma (S) receive 5040 cGy/28 fractions of radiation therapy (RT) and concurrent weekly cisplatin 30mg/m2 plus irinotecan 65 mg/m2 on weeks 1, 2, 4, and 5, followed by surgery 4–8 weeks after completion of RT. Additionally, pts receive weekly infusions of cetuximab 250 mg during RT, up to one week before surgery, and for 6 months following surgery. Results: Seventeen pts have been entered: male: female = 14:3, median age 54, ECOG PS 0:1 = 6:11, A:S = 17:0, stage IIA:IIB:III:IVA = 6:1:8:2, tumor location-esophagus-mid:lower:gastroesophageal junction = 1:4:12, >10% weight loss-yes:no = 8:9. Of 17 pts entered, 15 pts have proceeded to surgery, 1 pt died from Aspergillus infection resulting in respiratory failure and sepsis, and 1 pt is pending surgery. Of the 15 pts who underwent surgery, 2 (13%) had a complete pathologic response; pathologic stage for other pts: 0 = 1, I = 3, IIA = 3, IIB = 1, III = 4, IV = 1. Grade III/IV toxicity (17 pts) was: diarrhea 9 pts, neutropenia 9 pts, febrile neutropenia 5 pts, anorexia 5 pts, vomiting 4 pts, fatigue 3 pts, mucositis 1 pt. Chemotherapy dose attenuation was required for diarrhea in 5 pts, for neutropenia in 4 pts, and for folliculitis in 1 pt. One patient was removed from study during week 6 for prolonged diarrhea/ dehydration. Due to the 2-step design of the trial, accrual is on hold pending a 3rd required pathologic CR in the first 17 patients. Conclusions: Compared to other trials of irinotecan, cisplatin, radiation therapy, and surgery in similar groups of esophageal cancer patients, early results for this combination with cetuximab suggest a lower complete response rate and higher overall toxicity. Additional data will be available at ASCO. Supported by Bristol-Myers Squibb. No significant financial relationships to disclose.

scholarly journals A CASE REPORT OF SUCCESSFUL TREATMENT OF STAGE IV ESOPHAGEAL CANCER

2019 ◽  
Vol 18 (4) ◽  
pp. 106-111
Author(s):  
V. N. Khmelevskaya ◽  
P. A. Isaev ◽  
I. V. Gunko
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Stage Iv ◽  
Complete Response ◽  
Esophageal Stenosis ◽  
Advanced Esophageal Cancer ◽  
Cervical Esophageal Cancer ◽  
Scientific Center ◽  
Cervical Lymph Nodes ◽  
Fractionated Radiotherapy

Background. Esophageal cancer is among the ten most common cancers and causes-related mortality worldwide. Most patients present with an advanced stage tumor at diagnosis. To treat patients with esophageal cancer, radiation therapy in combination with chemotherapy is usually used. In the clinic of A.F. Tsyb Medical Radiological Scientific Center, patients with advanced esophageal cancer are treated with split-course radiotherapy delivered in two fractions (1–1.5 Gy) with a 4-hour interval. The positive effect is observed significantly earlier than in conventional radiotherapy.Case description. A 50-year-old male patient presented with complaints of hoarseness of voice and difficulty swallowing in February 2015. The patient was diagnosed with stage cТ4N2M1 cervical esophageal cancer (tumor length 3.5 cm) with metastases in cervical lymph nodes and the thyroid and esophageal stenosis (stage IV). Cytological examination revealed keratinizing squamous cell esophageal carcinoma. The tumor was considered inoperable. The patient underwent gastrostomy. Radiation therapy delivered to the tumor and metastases was performed 5 times a week using two lateral fields and one anterior field. The total radiation dose was 60 Gy. A complete response was achieved. Three courses of chemotherapy with carboplatin (AUC 6), paclitaxel (75 mg/m2 ) with a 21-day interval were administered 2 months after radiotherapy. In January 2016, new metastases in the thyroid were detected. Thyroidectomy with microsurgical neurolysis of the laryngeal nerves was performed. The patient is alive 3 years and 7 months after diagnosis.Conclusion. The use of nonconventional fractionated radiotherapy schedules in combination with chemotherapy allows satisfactory treatment outcomes in patients with advanced esophageal cancer to be obtained. 

Preoperative induction chemotherapy with docetaxel-cisplatin followed by concurrent docetaxel-cisplatin and radiation therapy in patients with locally advanced esophageal cancer: A prospective, multicenter phase ll trial of the Swiss Group for Clinical Cancer Research

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4562-4562
Author(s):  
T. Ruhstaller ◽  
L. Widmer ◽  
S. Balmer Majno ◽  
W. Mingrone ◽  
V. Hess ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Radiation Therapy ◽  
Gastroesophageal Junction ◽  
Locally Advanced ◽  
Preoperative Therapy ◽  
Tumor Regression Grade ◽  
Thoracic Esophagus ◽  
Advanced Esophageal Cancer ◽  
Community Based ◽  
Locally Advanced Esophageal Cancer

4562 Background: The role of preoperative therapy in patients (pts) with locally advanced esophageal cancer remains unclear. Non-randomized and randomized studies were often performed in single and highly specialized centers. The purpose of this study was to investigate 1) the efficacy and toxicity of preoperative docetaxel-cisplatin together with radiation therapy (RT) 2) the feasibility of a complex preoperative strategy in a community-based multicenter setting. Methods: Eligibility criteria: resectable, locally advanced (uT3 or uN1, T4 if deemed resectable) squamous cell carcinoma (SCC) or adenocarcinoma (AC) of the thoracic esophagus or gastroesophageal junction (Siewert type l); staged by EUS, CT and PET scan; age 18–70y; PS <2; normal organ functions. Treatment: 2 cycles of docetaxel 75mg/m2 and cisplatin 75mg/m2 q3w, followed by weekly x5 docetaxel 20mg/m2 and cisplatin 25mg/m2 with concomitant 45 Gy RT in 25 fractions; surgery 3- 8 weeks after RT. A two stage-design was used with two primary endpoints: 1) efficacy (TRG : tumor regression grade ); 2) feasibility (successful completion of entire therapy and being alive 30 days after surgery). Results: 66 pts, 56 males, were included from 11 institutions; median age 61y (35–70y); AC 53%; SCC 46%; 53 pts (80%) completed the preoperative therapy, underwent resection and were alive 30 days after surgery; 10 pts (15%) had no resection (4 progressive disease, 4 medical reasons, 2 patient’s refusal). Of 56 (85%) pts who had surgery, 51 pts had RO-resection (91%), 5 pts (9%) died due to complications after surgery (3 after > 30 days). Conclusion: Our trimodality treatment shows encouraging antineoplastic activity with 57% histopathological responders (TRG1 and 2) and acceptable feasibility in a community-based multicenter setting. [Table: see text] No significant financial relationships to disclose.

Enteral feeding during preoperative chemotherapy for patients with local advanced esophageal cancer: A feasibility study.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e16012-e16012
Author(s):  
Takashi Ogata ◽  
Hiroaki Osakabe ◽  
Shinsuke Nagasawa ◽  
Masato Nakazono ◽  
Yuta Kumazu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Feasibility Study ◽  
Preoperative Chemotherapy ◽  
Enteral Feeding ◽  
Advanced Esophageal Cancer ◽  
Local Advanced

The effect of adjuvant chemotherapy in patients without local nodal metastases following neoadjuvant chemoradiotherapy and esophagectomy for locally advanced esophageal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 111-111
Author(s):  
Christopher Duane Nevala-Plagemann ◽  
Samual Francis ◽  
Courtney Christine Cavalieri ◽  
Shane Lloyd ◽  
Ignacio Garrido-Laguna
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Adjuvant Chemotherapy ◽  
Adjuvant Therapy ◽  
Locally Advanced ◽  
Postoperative Chemotherapy ◽  
National Cancer Database ◽  
Nodal Metastases ◽  
Advanced Esophageal Cancer ◽  
Locally Advanced Esophageal Cancer

111 Background: Neoadjuvant chemoradiation therapy (CRT) followed by esophagectomy is the current standard of care for patients with locally advanced esophageal cancer. The potential benefit of additional postoperative chemotherapy is still under investigation. In this study, we utilized the National Cancer Database to assess the effect of adjuvant chemotherapy in patients who were found to have node negative disease (pN0) following surgery. Methods: Patients with locally advanced esophageal cancer who received neoadjuvant CRT followed by esophagectomy from 2004 to 2014 were retrospectively identified using the National Cancer Database. Patients who were postoperatively staged as pN0 were then separated based on whether or not they received adjuvant chemotherapy. Using Kaplan-Meier estimation and a multivariate cox regression analysis, the overall survival of those who received adjuvant therapy was then compared to those who received neoadjuvant CRT alone. Results: 3,159 patients with locally advanced esophageal cancer underwent neoadjuvant CRT and were found to be pN0 following surgery. 119 of these patients received postoperative chemotherapy. The 1, 5, and 8-year overall survival in those receiving adjuvant therapy was 95.9%, 49.9%, and 47.7% compared to 85.8%, 44.6%, and 33.0% in those receiving neoadjuvant CRT alone, respectively (p = 0.019). Based on multivariate analysis, receiving adjuvant chemotherapy was independently associated with increased overall survival (p = 0.011; HR 0.658; 95% CI, 0.476 to 0.908). Conclusions: Adjuvant chemotherapy may improve survival in patients with locally advance esophageal cancer who have no evidence of local nodal metastases following surgery. Additional clinical trials are needed to further confirm which patients may benefit from adjuvant therapy and to determine the optimal postoperative therapeutic regimen.

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