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Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation.

Authors
 Hae Won Kim  ;  Jie Hyun Kim  ;  Ik Jae Lee  ;  Jun Won Kim  ;  Yong Chan Lee  ;  Chang Geol Lee  ;  Jae Jun Park  ;  Young Hoon Youn  ;  Hyojin Park 
Citation
 DIGESTION, Vol.90(4) : 254-260, 2014 
Journal Title
 DIGESTION 
ISSN
 0012-2823 
Issue Date
2014
MeSH
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Carboplatin/administration & dosage ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/therapy* ; Chemoradiotherapy* ; Cisplatin/administration & dosage ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/therapy* ; Esophagoscopy ; Female ; Fluorouracil/administration & dosage ; Humans ; Lymph Nodes/pathology* ; Male ; Middle Aged ; Neoplasm Staging ; Neoplasm, Residual ; Remission Induction ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Treatment Outcome ; Tumor Burden
Keywords
Esophageal squamous cell carcinoma ; Concurrent chemoradiation ; Failure patterns ; Local control
Abstract
BACKGROUND/AIM: Little is known about the patterns of treatment failure following definitive chemoradiotherapy (CCRT), especially in esophageal squamous cell carcinoma (SCC). We evaluated definitive CCRT failure patterns and determined the predictive factors for treatment response in esophageal SCC. METHODS: We evaluated 136 consecutive patients with esophageal SCC treated with definitive CCRT. We evaluated the factors associated with complete remission (CR) after CCRT and analyzed the pattern of treatment failure of recurred patients and incomplete remission patients. The failures were categorized as either within (locoregional failure) or outside the radiation field (out-field failure). RESULTS: Fifty-seven patients achieved CR after CCRT. Consolidation chemotherapy was significantly associated with CR. Only 4 (7.0%) patients had CR after CCRT in patients with M1a node (Celiac or subclavian lymph nodes involvement by 6th AJCC). During follow-up, 74 patients (54.4%) experienced locoregional failure, 26 (19.1%) out-field failure, and 35 (25.7%) no failure. Esophageal obstruction prior to CCRT, residual tumor according to the first follow-up endoscopy, and poor follow-up computed tomography responses were significantly associated with locoregional failure. CONCLUSION: Approximately 70% of treatment failures were local failures. Future therapeutic strategies need to focus on improving local control to increase treatment outcomes of CCRT.
Full Text
http://www.karger.com/Article/FullText/368983
DOI
10.1159/000368983
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Kim, Hye Won(김혜원)
Park, Jae Jun(박재준)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138486
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