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Definitive chemoradiotherapy with capecitabine and cisplatin for elder patients with locally advanced squamous cell esophageal cancer

  • Ligang Xing
  • Yemin Liang
  • Jiandong ZhangEmail author
  • Peipei Wu
  • Deguo Xu
  • Fengjun Liu
  • Xinshuang Yu
  • Zhongmin Jiang
  • Xiaoming Song
  • Qi Zang
  • Wei Wang
Original Article – Clinical Oncology

Abstract

Purpose

The aim of this retrospective study is to evaluate the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) or sequential chemoradiotherapy (SCRT) with capecitabine and cisplatin for elderly patients with locally advanced esophageal squamous cell carcinoma (ESCC).

Methods

A total of 75 patients elder than 65 years with histologically proven stage II–III ESCC were enrolled, in whom 40 patients were treated with CCRT consisted of two cycles of intravenous cisplatin and oral capecitabine during and after radiotherapy and 35 patients were treated with SCRT as two cycles of capecitabine plus cisplatin before and after radiotherapy. Response rate, overall survival, progression-free survival and toxicity were compared.

Results

The overall response rate (CR + PR) in the CCRT group (91.6 %) was significantly higher than that in the SCRT group (67.7 %), P = 0.023. The median PFS and median OS were significantly higher in CCRT group (19.7 and 33.6 months) than those in SCRT group (11.6 and 15.7 months), P < 0.05. The acute toxic effect was more severe in the CCRT group than in the SCRT group, but the grade 3–4 acute toxicities were similar in two groups.

Conclusions

It suggested that both CCRT and SCRT with capecitabine and cisplatin are tolerable and effective for elderly patients with locally advanced ESCC. Concurrent CRT might be superior to SCRT.

Keywords

Chemoradiotherapy Capecitabine Cisplatin Esophageal cancer Elderly patients 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. al-Sarraf M, Martz K, Herskovic A et al (1997) Progress report of combined chemoradiotherapy versus radiotherapy alone in patients with esophageal cancer: an intergroup study. J Clin Oncol 15:277–284PubMedGoogle Scholar
  2. Anderson SE, Minsky BD, Bains M, Hummer A, Kelsen D, Ilson DH (2007) Combined modality chemoradiation in elderly oesophageal cancer patients. Br J Cancer 96:1823–1827. doi: 10.1038/sj.bjc.6603821 CrossRefPubMedPubMedCentralGoogle Scholar
  3. Bedenne L, Michel P, Bouche O et al (2007) Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol 25:1160–1168. doi: 10.1200/JCO.2005.04.7118 CrossRefPubMedGoogle Scholar
  4. Bonavina L, Incarbone R, Saino G, Clesi P, Peracchia A (2003) Clinical outcome and survival after esophagectomy for carcinoma in elderly patients. Dis Esophagus 16:90–93. doi: 10.1046/j.1442-2050.2003.00300.x CrossRefPubMedGoogle Scholar
  5. Cooper JS, Guo MD, Herskovic A et al (1999) Chemoradiotherapy of locally advanced esophageal cancer: long-term follow-up of a prospective randomized trial (RTOG 85-01). Radiation Therapy Oncology Group. JAMA 281:1623–1627. doi: 10.1001/jama.281.17.1623 CrossRefPubMedGoogle Scholar
  6. CTEP: Common Terminology Criteria for Adverse Events, Version 3.0. (2006) DCTD, NCI, NIH, DHHS. (http://ctep.cancer.gov)
  7. Daly JM, Fry WA, Little AG et al (2000) Esophageal cancer: results of an American College of Surgeons patient care evaluation study. J Am Coll Surg 190:562–572. doi: 10.1016/S1072-7515(00)00238-6 CrossRefPubMedGoogle Scholar
  8. Kim JG, Sohn SK, Kim DH et al (2005) Phase II study of concurrent chemoradiotherapy with capecitabine and cisplatin in patients with locally advanced squamous cell carcinoma of the head and neck. Br J Cancer 93:1117–1121. doi: 10.1038/sj.bjc.6602849 CrossRefPubMedPubMedCentralGoogle Scholar
  9. Koo DH, Park SI, Kim YH et al (2011) Phase II study of use of a single cycle of induction chemotherapy and concurrent chemoradiotherapy containing capecitabine/cisplatin followed by surgery for patients with resectable esophageal squamous cell carcinoma: long-term follow-up data. Cancer Chemother Pharmacol 69:655–663. doi: 10.1007/s00280-011-1750-5 CrossRefPubMedGoogle Scholar
  10. Lee SS, Kim SB, Park SI et al (2007) Capecitabine and cisplatin chemotherapy (XP) alone or sequentially combined chemoradiotherapy containing XP regimen in patients with three different settings of stage IV esophageal cancer. Jpn J Clin Oncol 37:829–835. doi: 10.1093/jjco/hym117 CrossRefPubMedGoogle Scholar
  11. Lee J, Im YH, Cho EY et al (2008) A phase II study of capecitabine and cisplatin (XP) as first-line chemotherapy in patients with advanced esophageal squamous cell carcinoma. Cancer Chemother Pharmacol 62:77–84. doi: 10.1007/s00280-007-0577-6 CrossRefPubMedGoogle Scholar
  12. Lee SJ, Ahn BM, Kim JG et al (2009) Definitive chemoradiotherapy with capecitabine and cisplatin in patients with esophageal cancer: a pilot study. J Korean Med Sci 24:120–125. doi: 10.3346/jkms.2009.24.1.120 CrossRefPubMedPubMedCentralGoogle Scholar
  13. Li BS, Zhou T, Wang ZT et al (2009) Phase I study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and Capecitabine, Cisplatin for locally advanced esophageal squamous cell carcinoma. Radiother Oncol 93:458–461. doi: 10.1016/j.radonc.2009.08.002 CrossRefPubMedGoogle Scholar
  14. Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55:74–108. doi: 10.3322/canjclin.55.2.74 CrossRefPubMedGoogle Scholar
  15. Rodel C, Grabenbauer GG, Papadopoulos T, Hohenberger W, Schmoll HJ, Sauer R (2003) Phase I/II trial of capecitabine, oxaliplatin, and radiation for rectal cancer. J Clin Oncol 21:3098–3104. doi: 10.1200/JCO.2003.02.505 CrossRefPubMedGoogle Scholar
  16. Schuller J, Cassidy J, Dumont E et al (2000) Preferential activation of capecitabine in tumor following oral administration to colorectal cancer patients. Cancer Chemother Pharmacol 45:291–297. doi: 10.1007/s002800050043 CrossRefPubMedGoogle Scholar
  17. Smith GL, Smith BD, Buchholz TA et al (2009) Patterns of care and locoregional treatment outcomes in older esophageal cancer patients: the SEER-Medicare Cohort. Int J Radiat Oncol Biol Phys 74:482–489. doi: 10.1016/j.ijrobp.2008.08.046 CrossRefPubMedGoogle Scholar
  18. Stahl M, Stuschke M, Lehmann N et al (2005) Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus. J Clin Oncol 23:2310–2317. doi: 10.1200/JCO.2005.00.034 CrossRefPubMedGoogle Scholar
  19. Suntharalingam M, Moughan J, Coia LR et al (2005) Outcome results of the 1996–1999 patterns of care survey of the national practice for patients receiving radiation therapy for carcinoma of the esophagus. J Clin Oncol 23:2325–2331. doi: 10.1200/JCO.2005.00.448 CrossRefPubMedGoogle Scholar
  20. Takeuchi S, Ohtsu A, Doi T et al (2007) A retrospective study of definitive chemoradiotherapy for elderly patients with esophageal cancer. Am J Clin Oncol 30:607–611. doi: 10.1097/COC.0b013e3180ca7c84 CrossRefPubMedGoogle Scholar
  21. Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216. doi: 10.1093/jnci/92.3.205 CrossRefPubMedGoogle Scholar
  22. Tougeron D, Di Fiore F, Thureau S et al (2008) Safety and outcome of definitive chemoradiotherapy in elderly patients with oesophageal cancer. Br J Cancer 99:1586–1592. doi: 10.1038/sj.bjc.6604749 CrossRefPubMedPubMedCentralGoogle Scholar
  23. van Hagen P, Hulshof MC, van Lanschot JJ et al (2012) Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366:2074–2084. doi: 10.1056/NEJMoa1112088 CrossRefPubMedGoogle Scholar
  24. Wakui R, Yamashita H, Okuma K et al (2010) Esophageal cancer: definitive chemoradiotherapy for elderly patients. Dis Esophagus 23:572–579. doi: 10.1111/j.1442-2050.2010.01062.x CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Ligang Xing
    • 1
  • Yemin Liang
    • 2
  • Jiandong Zhang
    • 3
    Email author
  • Peipei Wu
    • 1
  • Deguo Xu
    • 3
  • Fengjun Liu
    • 3
  • Xinshuang Yu
    • 3
  • Zhongmin Jiang
    • 4
  • Xiaoming Song
    • 4
  • Qi Zang
    • 4
  • Wei Wang
    • 4
  1. 1.Department of Radiation OncologyShandong Cancer Hospital and InstituteJinanChina
  2. 2.Department of Radiation OncologyQilu Hospital Affiliated to Shandong UniversityJinanChina
  3. 3.Department of Radiation OncologyQianfoshan Hospital Affiliated to Shandong UniversityJinanChina
  4. 4.Department of Thoracic SurgeryQianfoshan Hospital Affiliated to Shandong UniversityJinanChina

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