Definitive chemoradiotherapy versus esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma: A retrospective study
•For cT1bN0M0 esophageal SCC, DCRT was commonly used as a second choice treatment.•But DCRT showed equivalent survival to esophagectomy with less complications.•DCRT should be recommended as one of standard treatments for all cT1bN0M0 ESCC. This study aimed to determine the equivalence between defin...
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| Veröffentlicht in: | Radiotherapy and oncology 2021-09, Vol.162, p.112-118 |
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| container_title | Radiotherapy and oncology |
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| creator | Jo, Yoon Young Yu, Jesang Song, Kye Jin Jang, Jeong Yun Yoo, Ye Jin Kim, Sung-Bae Park, Sook Ryun Kim, Yong-Hee Kim, Hyeong Ryul Kim, Jong Hoon |
| description | •For cT1bN0M0 esophageal SCC, DCRT was commonly used as a second choice treatment.•But DCRT showed equivalent survival to esophagectomy with less complications.•DCRT should be recommended as one of standard treatments for all cT1bN0M0 ESCC.
This study aimed to determine the equivalence between definitive chemoradiotherapy (DCRT) and radical esophagectomy in clinical T1bN0M0 esophageal squamous cell carcinoma (ESCC).
Among 282 patients with cT1bN0M0 ESCC, 238 underwent radical esophagectomy and 44 underwent DCRT. Both treatments were retrospectively compared overall survival (OS), progression-free survival (PFS), and complications.
The DCRT group exhibited poorer patient characteristics than the surgery group, especially with mean age (73 vs. 63 years), Eastern Cooperative Oncology Group (ECOG) status, and Charlson Comorbidity Index (p |
| doi_str_mv | 10.1016/j.radonc.2021.07.006 |
| format | Article |
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This study aimed to determine the equivalence between definitive chemoradiotherapy (DCRT) and radical esophagectomy in clinical T1bN0M0 esophageal squamous cell carcinoma (ESCC).
Among 282 patients with cT1bN0M0 ESCC, 238 underwent radical esophagectomy and 44 underwent DCRT. Both treatments were retrospectively compared overall survival (OS), progression-free survival (PFS), and complications.
The DCRT group exhibited poorer patient characteristics than the surgery group, especially with mean age (73 vs. 63 years), Eastern Cooperative Oncology Group (ECOG) status, and Charlson Comorbidity Index (p < 0.001, each). The median follow-up duration was 49.5 (range, 0.4–97.0) and 45.5 months (range, 5.0–112.0) in the surgery and DCRT groups, respectively. In the DCRT group, clinical complete response was achieved in 43 patients (97.7%) at 1 month after treatment. The 5-year OS rates were 75.8% and 68.8% (p = 0.135) and the 5-year PFS were 63.8% and 57.8% (p = 0.637) for the surgery and DCRT groups, respectively. Local recurrence rates were identical between the two groups (11.4% and 11.4%), but the distant metastasis rate was lower in the DCRT group (n = 1, 2.27% vs. n = 29, 12.15%). Grade 3–4 hematologic toxicities were observed in 11 patients (25%) of the DCRT group, and 56 patients (23.5%) in the surgery group showed grade 3–5 surgical complications, including mortality (n = 5).
Based on the non-inferior survival rates, recurrence patterns, and complication rates without critical surgical mortality, DCRT was comparable to esophagectomy for cT1bN0 esophageal squamous cell carcinoma.</description><identifier>ISSN: 0167-8140</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/j.radonc.2021.07.006</identifier><language>eng</language><publisher>Elsevier B.V</publisher><subject>Comorbidity ; cT1bN0M0 ; Definitive chemoradiotherapy (DCRT) ; Esophageal squamous cell carcinoma (ESCC) ; Radical esophagectomy</subject><ispartof>Radiotherapy and oncology, 2021-09, Vol.162, p.112-118</ispartof><rights>2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c339t-f98a765b1be326973bec138c62128ebdf7fce84d0a53e878b1ee5cdd436dee853</citedby><cites>FETCH-LOGICAL-c339t-f98a765b1be326973bec138c62128ebdf7fce84d0a53e878b1ee5cdd436dee853</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0167814021066433$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids></links><search><creatorcontrib>Jo, Yoon Young</creatorcontrib><creatorcontrib>Yu, Jesang</creatorcontrib><creatorcontrib>Song, Kye Jin</creatorcontrib><creatorcontrib>Jang, Jeong Yun</creatorcontrib><creatorcontrib>Yoo, Ye Jin</creatorcontrib><creatorcontrib>Kim, Sung-Bae</creatorcontrib><creatorcontrib>Park, Sook Ryun</creatorcontrib><creatorcontrib>Kim, Yong-Hee</creatorcontrib><creatorcontrib>Kim, Hyeong Ryul</creatorcontrib><creatorcontrib>Kim, Jong Hoon</creatorcontrib><title>Definitive chemoradiotherapy versus esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma: A retrospective study</title><title>Radiotherapy and oncology</title><description>•For cT1bN0M0 esophageal SCC, DCRT was commonly used as a second choice treatment.•But DCRT showed equivalent survival to esophagectomy with less complications.•DCRT should be recommended as one of standard treatments for all cT1bN0M0 ESCC.
This study aimed to determine the equivalence between definitive chemoradiotherapy (DCRT) and radical esophagectomy in clinical T1bN0M0 esophageal squamous cell carcinoma (ESCC).
Among 282 patients with cT1bN0M0 ESCC, 238 underwent radical esophagectomy and 44 underwent DCRT. Both treatments were retrospectively compared overall survival (OS), progression-free survival (PFS), and complications.
The DCRT group exhibited poorer patient characteristics than the surgery group, especially with mean age (73 vs. 63 years), Eastern Cooperative Oncology Group (ECOG) status, and Charlson Comorbidity Index (p < 0.001, each). The median follow-up duration was 49.5 (range, 0.4–97.0) and 45.5 months (range, 5.0–112.0) in the surgery and DCRT groups, respectively. In the DCRT group, clinical complete response was achieved in 43 patients (97.7%) at 1 month after treatment. The 5-year OS rates were 75.8% and 68.8% (p = 0.135) and the 5-year PFS were 63.8% and 57.8% (p = 0.637) for the surgery and DCRT groups, respectively. Local recurrence rates were identical between the two groups (11.4% and 11.4%), but the distant metastasis rate was lower in the DCRT group (n = 1, 2.27% vs. n = 29, 12.15%). Grade 3–4 hematologic toxicities were observed in 11 patients (25%) of the DCRT group, and 56 patients (23.5%) in the surgery group showed grade 3–5 surgical complications, including mortality (n = 5).
Based on the non-inferior survival rates, recurrence patterns, and complication rates without critical surgical mortality, DCRT was comparable to esophagectomy for cT1bN0 esophageal squamous cell carcinoma.</description><subject>Comorbidity</subject><subject>cT1bN0M0</subject><subject>Definitive chemoradiotherapy (DCRT)</subject><subject>Esophageal squamous cell carcinoma (ESCC)</subject><subject>Radical esophagectomy</subject><issn>0167-8140</issn><issn>1879-0887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kMFu1DAQhi1UJLaFN-DgI5ek43hjOxwqVaWllRa4lLPl2BPWqyRObe-ifQjeGa-24sjJ0uifz_98hHxkUDNg4npXR-PCbOsGGlaDrAHEG7JiSnYVKCUvyKrEZKXYGt6Ry5R2ANAAlyvy5wsOfvbZH5DaLU6hkHzIW4xmOdIDxrRPFFNYtuYX2hymI_UzXUz2OOdEf_u8pXYsBGtG-sz67_AN_uXLKL3szRQKw-I4Umui9XOYzGd6SyPmGNJSqKfPU96743vydjBjwg-v7xX5-XD_fPdYbX58fbq73VSW8y5XQ6eMFG3PeuSN6CTv0TKurGhYo7B3gxwsqrUD03JUUvUMsbXOrblwiKrlV-TTmbvE8LLHlPXk06mhmbGU1U3bNl0nhGAluj5HbSmbIg56iX4y8agZ6JN9vdNn-_pkX4PUxX5ZuzmvYTnj4DHqZIsyi87HcrF2wf8f8BefP5Qg</recordid><startdate>202109</startdate><enddate>202109</enddate><creator>Jo, Yoon Young</creator><creator>Yu, Jesang</creator><creator>Song, Kye Jin</creator><creator>Jang, Jeong Yun</creator><creator>Yoo, Ye Jin</creator><creator>Kim, Sung-Bae</creator><creator>Park, Sook Ryun</creator><creator>Kim, Yong-Hee</creator><creator>Kim, Hyeong Ryul</creator><creator>Kim, Jong Hoon</creator><general>Elsevier B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202109</creationdate><title>Definitive chemoradiotherapy versus esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma: A retrospective study</title><author>Jo, Yoon Young ; Yu, Jesang ; Song, Kye Jin ; Jang, Jeong Yun ; Yoo, Ye Jin ; Kim, Sung-Bae ; Park, Sook Ryun ; Kim, Yong-Hee ; Kim, Hyeong Ryul ; Kim, Jong Hoon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c339t-f98a765b1be326973bec138c62128ebdf7fce84d0a53e878b1ee5cdd436dee853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Comorbidity</topic><topic>cT1bN0M0</topic><topic>Definitive chemoradiotherapy (DCRT)</topic><topic>Esophageal squamous cell carcinoma (ESCC)</topic><topic>Radical esophagectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jo, Yoon Young</creatorcontrib><creatorcontrib>Yu, Jesang</creatorcontrib><creatorcontrib>Song, Kye Jin</creatorcontrib><creatorcontrib>Jang, Jeong Yun</creatorcontrib><creatorcontrib>Yoo, Ye Jin</creatorcontrib><creatorcontrib>Kim, Sung-Bae</creatorcontrib><creatorcontrib>Park, Sook Ryun</creatorcontrib><creatorcontrib>Kim, Yong-Hee</creatorcontrib><creatorcontrib>Kim, Hyeong Ryul</creatorcontrib><creatorcontrib>Kim, Jong Hoon</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Radiotherapy and oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jo, Yoon Young</au><au>Yu, Jesang</au><au>Song, Kye Jin</au><au>Jang, Jeong Yun</au><au>Yoo, Ye Jin</au><au>Kim, Sung-Bae</au><au>Park, Sook Ryun</au><au>Kim, Yong-Hee</au><au>Kim, Hyeong Ryul</au><au>Kim, Jong Hoon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Definitive chemoradiotherapy versus esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma: A retrospective study</atitle><jtitle>Radiotherapy and oncology</jtitle><date>2021-09</date><risdate>2021</risdate><volume>162</volume><spage>112</spage><epage>118</epage><pages>112-118</pages><issn>0167-8140</issn><eissn>1879-0887</eissn><abstract>•For cT1bN0M0 esophageal SCC, DCRT was commonly used as a second choice treatment.•But DCRT showed equivalent survival to esophagectomy with less complications.•DCRT should be recommended as one of standard treatments for all cT1bN0M0 ESCC.
This study aimed to determine the equivalence between definitive chemoradiotherapy (DCRT) and radical esophagectomy in clinical T1bN0M0 esophageal squamous cell carcinoma (ESCC).
Among 282 patients with cT1bN0M0 ESCC, 238 underwent radical esophagectomy and 44 underwent DCRT. Both treatments were retrospectively compared overall survival (OS), progression-free survival (PFS), and complications.
The DCRT group exhibited poorer patient characteristics than the surgery group, especially with mean age (73 vs. 63 years), Eastern Cooperative Oncology Group (ECOG) status, and Charlson Comorbidity Index (p < 0.001, each). The median follow-up duration was 49.5 (range, 0.4–97.0) and 45.5 months (range, 5.0–112.0) in the surgery and DCRT groups, respectively. In the DCRT group, clinical complete response was achieved in 43 patients (97.7%) at 1 month after treatment. The 5-year OS rates were 75.8% and 68.8% (p = 0.135) and the 5-year PFS were 63.8% and 57.8% (p = 0.637) for the surgery and DCRT groups, respectively. Local recurrence rates were identical between the two groups (11.4% and 11.4%), but the distant metastasis rate was lower in the DCRT group (n = 1, 2.27% vs. n = 29, 12.15%). Grade 3–4 hematologic toxicities were observed in 11 patients (25%) of the DCRT group, and 56 patients (23.5%) in the surgery group showed grade 3–5 surgical complications, including mortality (n = 5).
Based on the non-inferior survival rates, recurrence patterns, and complication rates without critical surgical mortality, DCRT was comparable to esophagectomy for cT1bN0 esophageal squamous cell carcinoma.</abstract><pub>Elsevier B.V</pub><doi>10.1016/j.radonc.2021.07.006</doi><tpages>7</tpages></addata></record> |
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| subjects | Comorbidity cT1bN0M0 Definitive chemoradiotherapy (DCRT) Esophageal squamous cell carcinoma (ESCC) Radical esophagectomy |
| title | Definitive chemoradiotherapy versus esophagectomy in patients with clinical T1bN0M0 esophageal squamous cell carcinoma: A retrospective study |
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