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Optimal Adjuvant Treatment for Curatively Resected Thoracic Esophageal Squamous Cell Carcinoma: A Radiotherapy Perspective

Title
Optimal Adjuvant Treatment for Curatively Resected Thoracic Esophageal Squamous Cell Carcinoma: A Radiotherapy Perspective
Authors
Kim, Kyung HwanChang, Jee SukCha, Ji HyeLee, Lk JaeKim, Dae JoonCho, Byoung ChulPark, Kyung RanLee, Chang Geol
Ewha Authors
박경란
SCOPUS Author ID
박경란scopus
Issue Date
2017
Journal Title
CANCER RESEARCH AND TREATMENT
ISSN
1598-2998JCR Link2005-9256JCR Link
Citation
vol. 49, no. 1, pp. 168 - 177
Keywords
Esophageal neoplasmsSquamous cell carcinomaDrug therapyRadiotherapy
Publisher
KOREAN CANCER ASSOCIATION
Indexed
SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose The The purpose of this study was to evaluate the benefits of adjuvant treatment for curatively resected thoracic esophageal squamous cell carcinoma (ESCC) and determine the optimal adjuvant treatments. Materials and Methods One hundred ninety-five patients who underwent a curative resection for thoracic ESCC between 1994 and 2014 were reviewed retrospectively. Postoperatively, the patients received no adjuvant treatment (no-adjuvant group, n=68), adjuvant chemotherapy (AC group, n=62), radiotherapy (RT group, n=41), or chemoradiotherapy (CRT group, n=24). Chemotherapy comprised cisplatin and 5-fluorouracil administration every 3 weeks. The median RT dose was 45.0 Gy (range, 34.8 to 59.4 Gy). The overall survival (OS), disease free survival (DFS), locoregional recurrence (LRR), and distant metastasis (DM) rates were estimated. Results At a median follow-up duration of 42.2 months (range, 6.3 to 215.2 months), the 5-year OS and DFS were 37.6% and 31.4%, respectively. After adjusting for other clinicopathologic variables, the AC and CRT groups had a significantly better OS and DFS compared to the no-adjuvant group (p < 0.05). The LRR rate was significantly lower in the RT and CRT groups than in the no-adjuvant group (p < 0.05), whereas no significant difference was observed in the AC group. In the no-adjuvant and AC groups, 25% of patients received high-dose salvage RT due to LRR. The DM rates were similar. The anastomotic stenosis and leakage were similar in the treatment groups. Conclusion Adjuvant treatment might prolong survival after an ESCC resection, and RT contributes to a reduction of the LRR. Overall, the risks and benefits should be weighed properly when selecting the optimal adjuvant treatment.
DOI
10.4143/crt.2016.142
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의료원 > 의료원 > Journal papers
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