Nonsurgical management of esophageal adenocarcinoma.
BACKGROUND: The benefit of induction chemotherapy (IC) before chemoradiotherapy (CRT) for inoperable esophageal adenocarcinoma has not been established. To clarify toxicities and outcomes of combined modality treatment, we performed a retrospective review. MATERIALS AND METHODS: Sixty-eight consecu...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
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2011
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| _version_ | 1797094260179206144 |
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| author | Gujral, D Hawkins, M Leonulli, BG Ashley, S Chau, I Cunningham, D Tait, D |
| author_facet | Gujral, D Hawkins, M Leonulli, BG Ashley, S Chau, I Cunningham, D Tait, D |
| author_sort | Gujral, D |
| collection | OXFORD |
| description | BACKGROUND: The benefit of induction chemotherapy (IC) before chemoradiotherapy (CRT) for inoperable esophageal adenocarcinoma has not been established. To clarify toxicities and outcomes of combined modality treatment, we performed a retrospective review. MATERIALS AND METHODS: Sixty-eight consecutive patients were identified. Fifty-one patients had CRT, 17 had radiotherapy (RT). Fifty-eight received IC before RT. IC consisted of 4 cycles of platinum and fluoropyrimidines followed by CRT 54 Gy with concurrent infusional 5-fluorouracil (5-FU) or capecitabine. Response to IC was assessed at 3 months and response to CRT at 3 months. Time to progression (TTP) and overall survival (OS) are reported. RESULTS: Fifty-four patients were men and 14 were women, with median age 72 years (range, 42-87 years). There were 29 stage II, 33 stage III, 4 stage IVa, and 2 stage IVb tumors. The response 3 months after completion of treatment was 39.6%. No grade 4 toxicity was reported, but 10/58 patients had grade 3 toxicity from IC. The median TTP and OS from RT for the entire cohort was 12 months (95% confidence interval [CI], 7-18) and 16 months (95% CI, 5-27), respectively. The 1- and 2-year survival rates from diagnosis were 73% and 47%, respectively. There was no statistically significant difference in TTP or OS in patients who responded to IC compared with those who did not (median TTP 11 vs. 12 months, respectively; P = .8; median OS 15 vs. 14 months, respectively; P = .8). CONCLUSION: The outcome in patients with adenocarcinoma of the esophagus after CRT is comparable to unselected surgical series. Response to IC is not always an indicator of eventual outcome. |
| first_indexed | 2024-03-07T04:11:36Z |
| format | Journal article |
| id | oxford-uuid:c802a85e-399d-4bef-8121-56f5515f62ad |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:11:36Z |
| publishDate | 2011 |
| record_format | dspace |
| spelling | oxford-uuid:c802a85e-399d-4bef-8121-56f5515f62ad2022-03-27T06:49:15ZNonsurgical management of esophageal adenocarcinoma.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c802a85e-399d-4bef-8121-56f5515f62adEnglishSymplectic Elements at Oxford2011Gujral, DHawkins, MLeonulli, BGAshley, SChau, ICunningham, DTait, D BACKGROUND: The benefit of induction chemotherapy (IC) before chemoradiotherapy (CRT) for inoperable esophageal adenocarcinoma has not been established. To clarify toxicities and outcomes of combined modality treatment, we performed a retrospective review. MATERIALS AND METHODS: Sixty-eight consecutive patients were identified. Fifty-one patients had CRT, 17 had radiotherapy (RT). Fifty-eight received IC before RT. IC consisted of 4 cycles of platinum and fluoropyrimidines followed by CRT 54 Gy with concurrent infusional 5-fluorouracil (5-FU) or capecitabine. Response to IC was assessed at 3 months and response to CRT at 3 months. Time to progression (TTP) and overall survival (OS) are reported. RESULTS: Fifty-four patients were men and 14 were women, with median age 72 years (range, 42-87 years). There were 29 stage II, 33 stage III, 4 stage IVa, and 2 stage IVb tumors. The response 3 months after completion of treatment was 39.6%. No grade 4 toxicity was reported, but 10/58 patients had grade 3 toxicity from IC. The median TTP and OS from RT for the entire cohort was 12 months (95% confidence interval [CI], 7-18) and 16 months (95% CI, 5-27), respectively. The 1- and 2-year survival rates from diagnosis were 73% and 47%, respectively. There was no statistically significant difference in TTP or OS in patients who responded to IC compared with those who did not (median TTP 11 vs. 12 months, respectively; P = .8; median OS 15 vs. 14 months, respectively; P = .8). CONCLUSION: The outcome in patients with adenocarcinoma of the esophagus after CRT is comparable to unselected surgical series. Response to IC is not always an indicator of eventual outcome. |
| spellingShingle | Gujral, D Hawkins, M Leonulli, BG Ashley, S Chau, I Cunningham, D Tait, D Nonsurgical management of esophageal adenocarcinoma. |
| title | Nonsurgical management of esophageal adenocarcinoma. |
| title_full | Nonsurgical management of esophageal adenocarcinoma. |
| title_fullStr | Nonsurgical management of esophageal adenocarcinoma. |
| title_full_unstemmed | Nonsurgical management of esophageal adenocarcinoma. |
| title_short | Nonsurgical management of esophageal adenocarcinoma. |
| title_sort | nonsurgical management of esophageal adenocarcinoma |
| work_keys_str_mv | AT gujrald nonsurgicalmanagementofesophagealadenocarcinoma AT hawkinsm nonsurgicalmanagementofesophagealadenocarcinoma AT leonullibg nonsurgicalmanagementofesophagealadenocarcinoma AT ashleys nonsurgicalmanagementofesophagealadenocarcinoma AT chaui nonsurgicalmanagementofesophagealadenocarcinoma AT cunninghamd nonsurgicalmanagementofesophagealadenocarcinoma AT taitd nonsurgicalmanagementofesophagealadenocarcinoma |