A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly

BackgroundTo explore the efficacy and toxicity of simultaneous modulated accelerated radiotherapy (SMART) concurrently with cisplatin (CDDP) and S1 (tegafur/gimeracil/oteracil) in elderly patients with esophageal squamous cell carcinoma (ESCC).MethodsThis single-arm, phase II study enrolled patholog...

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Autores principales:	SuPing Guo, FangJie Liu, Hui Liu, YingJia Wu, XuHui Zhang, WenFeng Ye, GuangYu Luo, QiWen Li, NaiBin Chen, Nan Hu, Bin Wang, Jun Zhang, MaoSheng Lin, HuiXia Feng, Bo Qiu
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	chemoradiotherapy esophageal cancer elderly patients treatment-related toxicity survival outcome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/215b1fcc6b6b4ffab9e8cead394562b2
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spelling	oai:doaj.org-article:215b1fcc6b6b4ffab9e8cead394562b22021-11-30T21:03:59ZA Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly2234-943X10.3389/fonc.2021.760631https://doaj.org/article/215b1fcc6b6b4ffab9e8cead394562b22021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.760631/fullhttps://doaj.org/toc/2234-943XBackgroundTo explore the efficacy and toxicity of simultaneous modulated accelerated radiotherapy (SMART) concurrently with cisplatin (CDDP) and S1 (tegafur/gimeracil/oteracil) in elderly patients with esophageal squamous cell carcinoma (ESCC).MethodsThis single-arm, phase II study enrolled pathologically confirmed, stage II–IVa ESCC of 70–80 years old and Eastern Cooperative Oncology Group performance status (ECOG PS) 0–2. Patients received SMART (64 Gy to gross tumor volume and 48 Gy to clinical target volume in 30 fractions) with concurrent CDDP (day 1 of each week) and S1 (days 1–14, 22–35). The primary endpoint was objective response rate (ORR). The secondary endpoints included progression-free survival (PFS), overall survival (OS) and toxicities.ResultsThirty-seven eligible patients were analyzed with median follow-up of 25.7 months for all and 46.1 months for survivors. The ORR was 88.9%. Patients with baseline weight loss <5% (p=0.050) and nutritional risk index (NRI) ≥105.2 (p=0.023) had better tumor response. Median PFS was 13.8 months with 2-year PFS of 37.5%. Median OS was 27.7 months with 2-year OS of 57.5%. OS was significantly associated with ECOG PS (p=0.005), stage (p=0.014), gross tumor volume (p=0.004), baseline NRI (p=0.036), baseline C-reactive protein (CRP) level (p=0.003) and tumor response (p=0.000). CRP level (p=0.016) and tumor response (p=0.021) were independently prognostic of OS. ≥grade 3 anemia, neutropenia and thrombocytopenia occurred in 2.7%, 10.8% and 13.5% of patients; ≥grade 3 esophagitis and pneumonitis occurred in 18.9% and 2.7% of patient, respectively.ConclusionSMART concurrently with CDDP/S1 yielded satisfactory response rate, survival outcome and tolerable treatment-related toxicities in elderly patients with ESCC. Further studies are warranted to validate the results.SuPing GuoSuPing GuoSuPing GuoFangJie LiuFangJie LiuFangJie LiuFangJie LiuHui LiuHui LiuHui LiuHui LiuYingJia WuYingJia WuYingJia WuXuHui ZhangXuHui ZhangXuHui ZhangWenFeng YeWenFeng YeWenFeng YeGuangYu LuoGuangYu LuoGuangYu LuoQiWen LiQiWen LiQiWen LiQiWen LiNaiBin ChenNaiBin ChenNaiBin ChenNaiBin ChenNan HuNan HuNan HuNan HuBin WangBin WangBin WangJun ZhangJun ZhangJun ZhangMaoSheng LinMaoSheng LinMaoSheng LinHuiXia FengHuiXia FengHuiXia FengBo QiuBo QiuBo QiuBo QiuFrontiers Media S.A.articlechemoradiotherapyesophageal cancerelderly patientstreatment-related toxicitysurvival outcomeNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chemoradiotherapy esophageal cancer elderly patients treatment-related toxicity survival outcome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	chemoradiotherapy esophageal cancer elderly patients treatment-related toxicity survival outcome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 SuPing Guo SuPing Guo SuPing Guo FangJie Liu FangJie Liu FangJie Liu FangJie Liu Hui Liu Hui Liu Hui Liu Hui Liu YingJia Wu YingJia Wu YingJia Wu XuHui Zhang XuHui Zhang XuHui Zhang WenFeng Ye WenFeng Ye WenFeng Ye GuangYu Luo GuangYu Luo GuangYu Luo QiWen Li QiWen Li QiWen Li QiWen Li NaiBin Chen NaiBin Chen NaiBin Chen NaiBin Chen Nan Hu Nan Hu Nan Hu Nan Hu Bin Wang Bin Wang Bin Wang Jun Zhang Jun Zhang Jun Zhang MaoSheng Lin MaoSheng Lin MaoSheng Lin HuiXia Feng HuiXia Feng HuiXia Feng Bo Qiu Bo Qiu Bo Qiu Bo Qiu A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly
description	BackgroundTo explore the efficacy and toxicity of simultaneous modulated accelerated radiotherapy (SMART) concurrently with cisplatin (CDDP) and S1 (tegafur/gimeracil/oteracil) in elderly patients with esophageal squamous cell carcinoma (ESCC).MethodsThis single-arm, phase II study enrolled pathologically confirmed, stage II–IVa ESCC of 70–80 years old and Eastern Cooperative Oncology Group performance status (ECOG PS) 0–2. Patients received SMART (64 Gy to gross tumor volume and 48 Gy to clinical target volume in 30 fractions) with concurrent CDDP (day 1 of each week) and S1 (days 1–14, 22–35). The primary endpoint was objective response rate (ORR). The secondary endpoints included progression-free survival (PFS), overall survival (OS) and toxicities.ResultsThirty-seven eligible patients were analyzed with median follow-up of 25.7 months for all and 46.1 months for survivors. The ORR was 88.9%. Patients with baseline weight loss <5% (p=0.050) and nutritional risk index (NRI) ≥105.2 (p=0.023) had better tumor response. Median PFS was 13.8 months with 2-year PFS of 37.5%. Median OS was 27.7 months with 2-year OS of 57.5%. OS was significantly associated with ECOG PS (p=0.005), stage (p=0.014), gross tumor volume (p=0.004), baseline NRI (p=0.036), baseline C-reactive protein (CRP) level (p=0.003) and tumor response (p=0.000). CRP level (p=0.016) and tumor response (p=0.021) were independently prognostic of OS. ≥grade 3 anemia, neutropenia and thrombocytopenia occurred in 2.7%, 10.8% and 13.5% of patients; ≥grade 3 esophagitis and pneumonitis occurred in 18.9% and 2.7% of patient, respectively.ConclusionSMART concurrently with CDDP/S1 yielded satisfactory response rate, survival outcome and tolerable treatment-related toxicities in elderly patients with ESCC. Further studies are warranted to validate the results.
format	article
author	SuPing Guo SuPing Guo SuPing Guo FangJie Liu FangJie Liu FangJie Liu FangJie Liu Hui Liu Hui Liu Hui Liu Hui Liu YingJia Wu YingJia Wu YingJia Wu XuHui Zhang XuHui Zhang XuHui Zhang WenFeng Ye WenFeng Ye WenFeng Ye GuangYu Luo GuangYu Luo GuangYu Luo QiWen Li QiWen Li QiWen Li QiWen Li NaiBin Chen NaiBin Chen NaiBin Chen NaiBin Chen Nan Hu Nan Hu Nan Hu Nan Hu Bin Wang Bin Wang Bin Wang Jun Zhang Jun Zhang Jun Zhang MaoSheng Lin MaoSheng Lin MaoSheng Lin HuiXia Feng HuiXia Feng HuiXia Feng Bo Qiu Bo Qiu Bo Qiu Bo Qiu
author_facet	SuPing Guo SuPing Guo SuPing Guo FangJie Liu FangJie Liu FangJie Liu FangJie Liu Hui Liu Hui Liu Hui Liu Hui Liu YingJia Wu YingJia Wu YingJia Wu XuHui Zhang XuHui Zhang XuHui Zhang WenFeng Ye WenFeng Ye WenFeng Ye GuangYu Luo GuangYu Luo GuangYu Luo QiWen Li QiWen Li QiWen Li QiWen Li NaiBin Chen NaiBin Chen NaiBin Chen NaiBin Chen Nan Hu Nan Hu Nan Hu Nan Hu Bin Wang Bin Wang Bin Wang Jun Zhang Jun Zhang Jun Zhang MaoSheng Lin MaoSheng Lin MaoSheng Lin HuiXia Feng HuiXia Feng HuiXia Feng Bo Qiu Bo Qiu Bo Qiu Bo Qiu
author_sort	SuPing Guo
title	A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly
title_short	A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly
title_full	A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly
title_fullStr	A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly
title_full_unstemmed	A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly
title_sort	prospective phase ii study of simultaneous modulated accelerated radiotherapy concurrently with cddp/s1 for esophageal squamous cell carcinoma in the elderly
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/215b1fcc6b6b4ffab9e8cead394562b2
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A Prospective Phase II Study of Simultaneous Modulated Accelerated Radiotherapy Concurrently With CDDP/S1 for Esophageal Squamous Cell Carcinoma in the Elderly

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