Advertisement

Treatment outcomes according to the macroscopic tumor type in locally advanced esophageal squamous cell carcinoma treated by chemoradiotherapy

  • Katsumaro KuboEmail author
  • Koichi Wadasaki
  • Katsunori Shinozaki
Original Article
  • 25 Downloads

Abstract

Purpose

To identify predictive factors for local control of locally advanced esophageal cancer by chemoradiotherapy, the relationship between clinical features, including macroscopic tumor type, and treatment outcome was analyzed in 83 patients.

Materials and methods

Macroscopic tumor type was defined by endoscopy as follows: type 1: protruding type; type 2: ulcerative and localized type; type 3: ulcerative and infiltrative type; type 4: diffusely infiltrative type; and type 5: unclassifiable type. We analyzed the overall survival, cause-specific survival, local progression-free rate, and predictive factors for locally advanced esophageal cancer after chemoradiotherapy.

Results

The median follow-up period at the time of evaluation was 59 months among survivors. The 5-year overall survival, cause-specific survival, and local progression-free rates for type 1 and other types were 37.0% and 23.3% (P = 0.4255), 71.8% and 30.3% (P = 0.0325), and 100% and 63.3% (P = 0.0246), respectively. Macroscopic tumor type (type 1) was the most significant predictive factor of cause-specific survival and local progression-free rates.

Conclusions

Macroscopic tumor type 1 was the significant favorable predictive factor for local control. The study results suggested that the macroscopic tumor type was useful in predicting tumor responses.

Keywords

Esophageal cancer Chemoradiotherapy Endoscopy 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

References

  1. 1.
    National Cancer Center, Center for Cancer Control and Information Services. Latest cancer statistics 2016. https://ganjoho.jp/reg_stat/statistics/stat/summary.html. Accessed 31 Oct 2018.
  2. 2.
    Ozawa S, Tachimori Y, Baba H, Matsubara H, Muro K, Numasaki H, et al. Comprehensive registry of esophageal cancer in Japan, 2002. Esophagus. 2010;7:7–22.CrossRefGoogle Scholar
  3. 3.
    Murakami M, Kuroda Y, Nakajima T, Okamoto Y, Mizowaki T, Kusumi F, et al. Comparison between chemoradiation protocol intended for organ preservation and conventional surgery for clinical T1–T2 esophageal carcinoma. Int J Radiat Oncol Biol Phys. 1999;45:277–84.CrossRefGoogle Scholar
  4. 4.
    Hironaka S, Ohtsu A, Boku N, Muto M, Nagashima F, Saito H, et al. Nonrandomized comparison between definitive chemoradiotherapy and radical surgery in patients with T (2–3) N (any) M (0) squamous cell carcinoma of the esophagus. Int J Radiat Oncol Biol Phys. 2003;57:425–33.CrossRefGoogle Scholar
  5. 5.
    Ohtsu A, Boku N, Muro K, Chin K, Muto M, Yoshida S, et al. Definitive chemoradiotherapy for T4 and/or M1 lymph node squamous cell carcinoma of the esophagus. J Clin Oncol. 1999;17:2915–21.CrossRefGoogle Scholar
  6. 6.
    Nishimura Y, Suzuki M, Nakamatsu K, Kanamori S, Yagyu Y, Shigeoka H. Prospective trial of concurrent chemoradiotherapy with protracted infusion of 5-fluorouracil and cisplatin for T4 esophageal cancer with or without fistula. Int J Radiat Oncol Biol Phys. 2002;53:134–9.CrossRefGoogle Scholar
  7. 7.
    Ishida K, Ando N, Yamamoto S, Ide H, Shioda M. Phase II study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus: a Japan Esophageal Oncology Group (JEOG) /Japan Clinical Oncology Group trial (JCOG9516). Jpn J Clin Oncol. 2004;34:615–9.CrossRefGoogle Scholar
  8. 8.
    Wong RK, Malthaner RA, Zuraw L, Rumble RB. Combined modality radiotherapy and chemotherapy in nonsurgical management of localized carcinoma of the esophagus: a practice guideline. Int J Radiat Oncol Biol Phys. 2003;55:930–42.CrossRefGoogle Scholar
  9. 9.
    Kato K, Muro K, Minashi K, Ohtsu A, Ishikura S, Boku N, et al. Phase II study of chemoradiotherapy with 5-fluorouracil and cisplatin for stage II-III esophageal squamous cell carcinoma: JCOG trial (JCOG 9906). Int J Radiat Oncol Biol Phys. 2011;81:684–90.CrossRefGoogle Scholar
  10. 10.
    Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluoroiracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG 9907). Ann Surg Oncol. 2012;19:68–74.CrossRefGoogle Scholar
  11. 11.
    Amini A, Ajani J, Komaki R, Allen PK, Minsky BD, Blum M, et al. Factors associated with local-regional failure after definitive chemoradiation for locally advanced esophageal cancer. Ann Surg Oncol. 2014;21:306–14.CrossRefGoogle Scholar
  12. 12.
    Kim HW, Kim JH, Lee IJ, Kim JW, Lee YC, Lee CG, et al. Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation. Digestion. 2014;90:254–60.CrossRefGoogle Scholar
  13. 13.
    Haefner MF, Lang K, Krung D, Koerber SA, Uhlmann L, Kieser M, et al. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy. J Radiat Res. 2015;56:742–9.CrossRefGoogle Scholar
  14. 14.
    Chen Y, Zhang Z, Jiang G, Zhao K. Grass tumor volume is the prognostic factor for squamous cell esophageal cancer patients treated with definitive radiotherapy. J Thorac Dis. 2016;8:1155–61.CrossRefGoogle Scholar
  15. 15.
    Luo Y, Mao Q, Wang X, Yu J, Li M. Radiotherapy for esophageal carcinoma: dose, response and survival. Cancer Manag Res. 2018;10:13–211.CrossRefGoogle Scholar
  16. 16.
    Sakanaka K, Ishida Y, Fujii K, Itasaka S, Miyamoto S, Horimatsu T, et al. Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma. Radiat Oncol. 2018;13:7.CrossRefGoogle Scholar
  17. 17.
    Japan Esophageal Society. Japanese classification of esophageal cancer, 11th edition: part II and III. Esophagus. 2017;14:37–65.CrossRefGoogle Scholar
  18. 18.
    Murakami Y, Hamai Y, Emi M, Hihara J, Imano N, Takeuchi Y, et al. Long-term results of neoadjuvant chemoradiotherapy using cisplatin and 5-fluorouracil followed by esophagectomy for resectable, locally advanced esophageal squamous cell carcinoma. J Radiat Res. 2018;59:616–24.CrossRefGoogle Scholar
  19. 19.
    Versteijine E, van Laarhoven HW, van Hooft JE, van Os RM, Geijsen ED, van Berge Henegouwen MI, et al. Definitive chemoradiation for patients with inoperable and/or unresectable esophageal cancer: locoregional recurrence pattern. Dis Esophagus. 2015;28:453–9.CrossRefGoogle Scholar
  20. 20.
    Shen WB, Zhu SC, Gao HM, Li YM, Su JW, Li J, et al. Analysis of failure patterns in patients with resectable esophageal squamous cell carcinoma receiving chemoradiotherapy. J Cancer Res Ther. 2016;12:62–8.CrossRefGoogle Scholar
  21. 21.
    Morita K, Takagi I, Watanabe M, Niwa K, Kanazawa H. Relationship between the radiologic features of esophageal cancer and the local control by radiation therapy. Cancer. 1985;55:2668–766.CrossRefGoogle Scholar

Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  • Katsumaro Kubo
    • 1
    Email author
  • Koichi Wadasaki
    • 1
  • Katsunori Shinozaki
    • 2
  1. 1.Department of Radiation OncologyHiroshima Prefectural HospitalHiroshimaJapan
  2. 2.Department of Clinical OncologyHiroshima Prefectural HospitalHiroshimaJapan

Personalised recommendations