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Therapeutic results of proton beam therapy with concurrent chemotherapy for cT1 esophageal cancer and salvage endoscopic therapy for local recurrence

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Abstract

Background

Proton beam therapy (PBT) with concurrent chemotherapy is promising for esophageal squamous cell carcinoma (ESCC). The aim of study was to evaluate the outcome of concurrent chemo-proton therapy (CCPT), i.e., PBT with concurrent chemotherapy for cT1 ESCC and the salvage endoscopic therapy for local recurrence.

Methods

Patients with clinical T1 ESCC who underwent CCPT (60 GyE) between April 2013 and April 2017 at the National Cancer Center Hospital East were investigated. The efficacy of CCPT at the primary site was evaluated via endoscopy; primary complete response (CR) was defined as disappearance of the tumor lesion/ulcer and absence of cancer cells on biopsy. Endoscopic evaluation was performed with the same protocol of conventional chemoradiotherapy. Local recurrence after CCPT was treated with endoscopic resection for cT1a and with esophagectomy or photodynamic therapy for cT1b+.

Results

Of the 44 patients (median age, 70 years) that underwent CCPT, 43 patients (98%) achieved primary CR. Among the 44 patients, the 3-year overall survival rate was 95.2%. Five patients (11%) developed local recurrence without regional lymph node or distant metastasis and received endoscopic resection or photodynamic therapy. All five patients were alive with no recurrence after a median 23 months.

Conclusions

The results suggest that CCPT is an effective treatment for cT1 ESCC and careful endoscopic follow-up allows preferable local control with salvage endoscopic treatment.

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Authors and Affiliations

  1. Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan

    Daiki Sato, Tomohiro Kadota, Kensuke Shinmura, Keisuke Hori, Yusuke Yoda, Yasuhiro Oono, Hiroaki Ikematsu & Tomonori Yano

  2. Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, 113-8421, Japan

    Daiki Sato & Tetsuo Akimoto

  3. Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan

    Atsushi Motegi, Sadamoto Zenda & Tetsuo Akimoto

  4. Department of Gastroenterology and Oncology, National Cancer Center Hospital East, Kashiwa, Japan

    Takashi Kojima & Hideaki Bando

Authors
  1. Daiki Sato
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  2. Atsushi Motegi
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  3. Tomohiro Kadota
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  4. Takashi Kojima
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  5. Hideaki Bando
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  6. Kensuke Shinmura
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  7. Keisuke Hori
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  8. Yusuke Yoda
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  9. Yasuhiro Oono
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  10. Sadamoto Zenda
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  11. Hiroaki Ikematsu
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  12. Tetsuo Akimoto
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  13. Tomonori Yano
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Corresponding author

Correspondence to Tomonori Yano.

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Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Institutional Review Board of the National Cancer Center Japan; approval no. 2017-434), performed according to the Epidemiological Study Guideline issued by the Japan Ministry of Health, Labor, and Welfare and the ethical principles of the revised Declaration of Helsinki.

Conflict of interest

All authors declare that they have no conflict of interest.

Informed consent

Informed consent or substitute for it was obtained from all patients for being included in the study.

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Sato, D., Motegi, A., Kadota, T. et al. Therapeutic results of proton beam therapy with concurrent chemotherapy for cT1 esophageal cancer and salvage endoscopic therapy for local recurrence. Esophagus 17, 305–311 (2020). https://doi.org/10.1007/s10388-020-00715-y

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  • DOI: https://doi.org/10.1007/s10388-020-00715-y

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