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High-dose Versus Standard-dose Radiotherapy with Concurrent Chemotherapy in Stages II-III Esophageal Cancer

 Yang-Gun Suh  ;  Ik Jae Lee  ;  Wong Sub Koom  ;  Jihye Cha  ;  Jong Young Lee  ;  Soo Kon Kim  ;  Chang Geol Lee 
 Japanese Journal of Clinical Oncology, Vol.44(6) : 534-540, 2014 
Journal Title
 Japanese Journal of Clinical Oncology 
Issue Date
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Chemoradiotherapy*/adverse effects ; Chemoradiotherapy*/methods ; Cisplatin/administration & dosage ; Disease-Free Survival ; Dose-Response Relationship, Radiation ; Drug Administration Schedule ; Esophageal Neoplasms/drug therapy* ; Esophageal Neoplasms/pathology ; Esophageal Neoplasms/radiotherapy* ; Esophageal Stenosis/etiology ; Female ; Fluorouracil/administration & dosage ; Follow-Up Studies ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Staging ; Platinum Compounds/administration & dosage ; Prognosis ; Radiation Pneumonitis/etiology ; Radiotherapy Dosage ; Retrospective Studies ; Risk Factors ; Taxoids/administration & dosage ; Treatment Failure ; Treatment Outcome
chemotherapy ; concurrent chemo-radiotherapy ; esophageal cancer ; radiotherapy
OBJECTIVE: In this study, we investigated the effects of radiotherapy ≥60 Gy in the setting of concurrent chemo-radiotherapy for treating patients with Stages II-III esophageal cancer. METHODS:A total of 126 patients treated with 5-fluorouracilbased concurrent chemo-radiotherapy between January 1998 and February 2008 were retrospectively reviewed. Among these patients, 49 received a total radiation dose of <60 Gy (standard-dose group), while 77 received a total radiation dose of ≥60 Gy (high-dose group). The median doses in the standard- and high-dose groups were 54 Gy (range, 45-59.4 Gy) and 63 Gy (range, 60-81 Gy), respectively. RESULTS:The high-dose group showed significantly improved locoregional control (2-year locoregional control rate, 69 versus 32%, P < 0.01) and progression-free survival (2-year progression-free survival, 47 versus 20%, P = 0.01) than the standard-dose group. Median overall survival in the high- and the standard-dose groups was 28 and 18 months, respectively (P = 0.26). In multivariate analysis, 60 Gy or higher radiotherapy was a significant prognostic factor for improved locoregional control, progression-free survival and overall survival. No significant differences were found in frequencies of late radiation pneumonitis, post-treatment esophageal stricture or treatment-related mortality between the two groups. CONCLUSIONS:High-dose radiotherapy of 60 Gy or higher with concurrent chemotherapy improved locoregional control and progression-free survival without a significant increase of in treatment-related toxicity in patients with Stages II-III esophageal cancer. Our study could provide the basis for future randomized clinical trials.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Suh, Yang Gun(서양권)
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
Cha, Ji Hye(차지혜)
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