Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study

PurposeWe aimed to evaluate the long-term outcomes of concurrent chemoradiotherapy (CCRT) with a simultaneous integrated boost (SIB) of radiotherapy for esophageal squamous cell carcinoma (ESCC).Methods and MaterialsEighty-seven patients with primary ESCC enrolled in this phase II trial. The majorit...

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Autores principales:	Chuangzhen Chen, Jianzhou Chen, Ting Luo, Siyan Wang, Hong Guo, Chengbing Zeng, Yanxuan Wu, Weitong Liu, Ruihong Huang, Tiantian Zhai, Zhijian Chen, Derui Li
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	esophageal cancer chemoradiotherapy simultaneous integrated boost long-term outcomes clinical trial Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/4cef534916bc449696f63259c9ef1eb2
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spelling	oai:doaj.org-article:4cef534916bc449696f63259c9ef1eb22021-11-18T06:28:14ZLate Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study2234-943X10.3389/fonc.2021.738936https://doaj.org/article/4cef534916bc449696f63259c9ef1eb22021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.738936/fullhttps://doaj.org/toc/2234-943XPurposeWe aimed to evaluate the long-term outcomes of concurrent chemoradiotherapy (CCRT) with a simultaneous integrated boost (SIB) of radiotherapy for esophageal squamous cell carcinoma (ESCC).Methods and MaterialsEighty-seven patients with primary ESCC enrolled in this phase II trial. The majority (92.0%) had locoregionally advanced disease. They underwent definitive chemoradiotherapy. The radiotherapy doses were 66 Gy for the gross tumor and 54 Gy for the subclinical disease. Doses were simultaneously administered in 30 fractions over 6 weeks. The patients also underwent concurrent and adjuvant chemotherapy, which comprised cisplatin and fluorouracil. The study end points were acute and late toxicities, first site of failure, locoregional tumor control, and overall survival rates.ResultsThe median follow-up time was 65.7 (range, 2.2-97.5) months for all patients and 81.5 (range, 19.4-97.5) months for those alive. There were 17 cases (19.5%) of severe late toxicities, including four cases (4.6%) of grade 5 and seven (8.0%) of grade 3 esophageal ulceration, four (4.6%) of grade 3 esophageal stricture, and two (2.3%) of grade 3 radiation-induced pneumonia. Twenty-three (26.4%) patients had locoregional disease progression. Most (86.7%) locally progressive lesions were within the dose-escalation region in the initial radiation plan, while majority of the recurrent lymph nodes were found out-of-field (83.3%) and in the supraclavicular region (75.0%). The 1-, 2-, 3-, and 5-year locoregional tumor control and overall survival rates were 79.2%, 72.4%, 72.4%, 70.8%, and 82.8%, 66.6%, 61.9%, 58.4%, respectively. Incomplete tumor response, which was assessed immediately after CCRT was an independent risk predictor of disease progression and death in ESCC patients.ConclusionsCCRT with SIB was well tolerated in ESCC patients during treatment and long-term follow-up. Moreover, patients who underwent CCRT with SIB exhibited improved local tumor control and had better survival outcomes compared to historical data of those who had standard-dose radiotherapy.Chuangzhen ChenJianzhou ChenJianzhou ChenTing LuoTing LuoSiyan WangHong GuoChengbing ZengYanxuan WuWeitong LiuWeitong LiuRuihong HuangTiantian ZhaiZhijian ChenZhijian ChenDerui LiFrontiers Media S.A.articleesophageal cancerchemoradiotherapysimultaneous integrated boostlong-term outcomesclinical trialNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	esophageal cancer chemoradiotherapy simultaneous integrated boost long-term outcomes clinical trial Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	esophageal cancer chemoradiotherapy simultaneous integrated boost long-term outcomes clinical trial Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Chuangzhen Chen Jianzhou Chen Jianzhou Chen Ting Luo Ting Luo Siyan Wang Hong Guo Chengbing Zeng Yanxuan Wu Weitong Liu Weitong Liu Ruihong Huang Tiantian Zhai Zhijian Chen Zhijian Chen Derui Li Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study
description	PurposeWe aimed to evaluate the long-term outcomes of concurrent chemoradiotherapy (CCRT) with a simultaneous integrated boost (SIB) of radiotherapy for esophageal squamous cell carcinoma (ESCC).Methods and MaterialsEighty-seven patients with primary ESCC enrolled in this phase II trial. The majority (92.0%) had locoregionally advanced disease. They underwent definitive chemoradiotherapy. The radiotherapy doses were 66 Gy for the gross tumor and 54 Gy for the subclinical disease. Doses were simultaneously administered in 30 fractions over 6 weeks. The patients also underwent concurrent and adjuvant chemotherapy, which comprised cisplatin and fluorouracil. The study end points were acute and late toxicities, first site of failure, locoregional tumor control, and overall survival rates.ResultsThe median follow-up time was 65.7 (range, 2.2-97.5) months for all patients and 81.5 (range, 19.4-97.5) months for those alive. There were 17 cases (19.5%) of severe late toxicities, including four cases (4.6%) of grade 5 and seven (8.0%) of grade 3 esophageal ulceration, four (4.6%) of grade 3 esophageal stricture, and two (2.3%) of grade 3 radiation-induced pneumonia. Twenty-three (26.4%) patients had locoregional disease progression. Most (86.7%) locally progressive lesions were within the dose-escalation region in the initial radiation plan, while majority of the recurrent lymph nodes were found out-of-field (83.3%) and in the supraclavicular region (75.0%). The 1-, 2-, 3-, and 5-year locoregional tumor control and overall survival rates were 79.2%, 72.4%, 72.4%, 70.8%, and 82.8%, 66.6%, 61.9%, 58.4%, respectively. Incomplete tumor response, which was assessed immediately after CCRT was an independent risk predictor of disease progression and death in ESCC patients.ConclusionsCCRT with SIB was well tolerated in ESCC patients during treatment and long-term follow-up. Moreover, patients who underwent CCRT with SIB exhibited improved local tumor control and had better survival outcomes compared to historical data of those who had standard-dose radiotherapy.
format	article
author	Chuangzhen Chen Jianzhou Chen Jianzhou Chen Ting Luo Ting Luo Siyan Wang Hong Guo Chengbing Zeng Yanxuan Wu Weitong Liu Weitong Liu Ruihong Huang Tiantian Zhai Zhijian Chen Zhijian Chen Derui Li
author_facet	Chuangzhen Chen Jianzhou Chen Jianzhou Chen Ting Luo Ting Luo Siyan Wang Hong Guo Chengbing Zeng Yanxuan Wu Weitong Liu Weitong Liu Ruihong Huang Tiantian Zhai Zhijian Chen Zhijian Chen Derui Li
author_sort	Chuangzhen Chen
title	Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study
title_short	Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study
title_full	Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study
title_fullStr	Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study
title_full_unstemmed	Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study
title_sort	late toxicities, failure patterns, local tumor control, and survival of esophageal squamous cell carcinoma patients after chemoradiotherapy with a simultaneous integrated boost: a 5-year phase ii study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/4cef534916bc449696f63259c9ef1eb2
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Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study

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