Long-term results of definitive radiochemotherapy in locally advanced cancers of the cervical esophagus. Issue 7 (1st October 2014)

• Record Type: Journal Article
• Authors: Gkika, E.; Gauler, T.; Eberhardt, W.; Stahl, M.; Stuschke, M.; Pöttgen, C.
• Is Part Of: Diseases of the esophagus. Volume 27:Issue 7(2014)
• Page Start: 678
• Page End: 684
• Publication Date: 2014-10-01
• Subjects: cervical -- chemoradiation -- esophageal cancer -- long-term survival; Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1111/dote.12146
• Languages: English
• ISSNs: 1120-8694

Abstract

Summary: The aim of this study was to retrospectively analyze the long-term effectiveness of combined chemoradiation as the definitive treatment of locally advanced cancers of the cervical esophagus. Patients received high-dose external beam radiotherapy and concurrent cisplatin-based chemotherapy. Some patients received intraluminal brachytherapy as a boost. In addition, a majority of the patients received cisplatin-based induction chemotherapy before definitive chemoradiation. Fifty-five patients (46 men, 9 women, median age 58 years, range 35–72 years) with cancers of the cervical esophagus (stage II : 20; stage III : 35 patients) were treated with definitive chemoradiation (median dose 60 G y, range 50–70 G y). Actuarial overall survival rates at 2, 3, 5, and 10 years were 35%, 29%, 25%, and 10%, respectively. Thirteen long-term survivors were observed with a follow-up of more than 5 years. Neither gender nor age, tumor length, tumor grade, or clinically detectable lymph node metastases was significant prognostic factors for survival. Twenty-four patients (44%) developed local or regional recurrences, 15 (27%) distant metastases, and 8 (15%) patients developed a second malignancy. Acute and late toxicity of this treatment schedule was moderate. Concurrent chemoradiation offers a chance of long-term survival for locally advanced unresectable carcinomas of the cervical esophagus, with long-term survival rates above 24% and acceptable toxicity. These results substantiate the use of chemoradiation as a curative treatment option for cervical esophageal cancer.