Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation

Hae Won Kim, Jie-Hyun Kim, Ik Jae Lee, Jun Won Kim, Yongchan Lee, Chang Geol Lee, Jae Jun Park, Young Hoon Youn, HyoJin Park

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background/Aim: Little is known about the patterns of treatment failure following definitive chemoradiotherapy (CCRT), especially in esophageal squamous cell carcinoma (SCC). We evaluated definitive CCRT failure patterns and determined the predictive factors for treatment response in esophageal SCC. Methods: We evaluated 136 consecutive patients with esophageal SCC treated with definitive CCRT. We evaluated the factors associated with complete remission (CR) after CCRT and analyzed the pattern of treatment failure of recurred patients and incomplete remission patients. The failures were categorized as either within (locoregional failure) or outside the radiation field (out-field failure). Results: Fifty-seven patients achieved CR after CCRT. Consolidation chemotherapy was significantly associated with CR. Only 4 (7.0%) patients had CR after CCRT in patients with M1a node (Celiac or subclavian lymph nodes involvement by 6th AJCC). During follow-up, 74 patients (54.4%) experienced locoregional failure, 26 (19.1%) out-field failure, and 35 (25.7%) no failure. Esophageal obstruction prior to CCRT, residual tumor according to the first follow-up endoscopy, and poor follow-up computed tomography responses were significantly associated with locoregional failure. Conclusion: Approximately 70% of treatment failures were local failures. Future therapeutic strategies need to focus on improving local control to increase treatment outcomes of CCRT.

Original languageEnglish
Pages (from-to)254-260
Number of pages7
JournalDigestion
Volume90
Issue number4
DOIs
Publication statusPublished - 2014 Jan 1

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Treatment Failure
Consolidation Chemotherapy
Residual Neoplasm
Chemoradiotherapy
Esophageal Squamous Cell Carcinoma
Abdomen
Endoscopy
Lymph Nodes
Tomography
Radiation
Therapeutics

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Kim, Hae Won ; Kim, Jie-Hyun ; Lee, Ik Jae ; Kim, Jun Won ; Lee, Yongchan ; Lee, Chang Geol ; Park, Jae Jun ; Youn, Young Hoon ; Park, HyoJin. / Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation. In: Digestion. 2014 ; Vol. 90, No. 4. pp. 254-260.
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abstract = "Background/Aim: Little is known about the patterns of treatment failure following definitive chemoradiotherapy (CCRT), especially in esophageal squamous cell carcinoma (SCC). We evaluated definitive CCRT failure patterns and determined the predictive factors for treatment response in esophageal SCC. Methods: We evaluated 136 consecutive patients with esophageal SCC treated with definitive CCRT. We evaluated the factors associated with complete remission (CR) after CCRT and analyzed the pattern of treatment failure of recurred patients and incomplete remission patients. The failures were categorized as either within (locoregional failure) or outside the radiation field (out-field failure). Results: Fifty-seven patients achieved CR after CCRT. Consolidation chemotherapy was significantly associated with CR. Only 4 (7.0{\%}) patients had CR after CCRT in patients with M1a node (Celiac or subclavian lymph nodes involvement by 6th AJCC). During follow-up, 74 patients (54.4{\%}) experienced locoregional failure, 26 (19.1{\%}) out-field failure, and 35 (25.7{\%}) no failure. Esophageal obstruction prior to CCRT, residual tumor according to the first follow-up endoscopy, and poor follow-up computed tomography responses were significantly associated with locoregional failure. Conclusion: Approximately 70{\%} of treatment failures were local failures. Future therapeutic strategies need to focus on improving local control to increase treatment outcomes of CCRT.",
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Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation. / Kim, Hae Won; Kim, Jie-Hyun; Lee, Ik Jae; Kim, Jun Won; Lee, Yongchan; Lee, Chang Geol; Park, Jae Jun; Youn, Young Hoon; Park, HyoJin.

In: Digestion, Vol. 90, No. 4, 01.01.2014, p. 254-260.

Research output: Contribution to journalArticle

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T1 - Local control may be the key in improving treatment outcomes of esophageal squamous cell carcinoma undergoing concurrent chemoradiation

AU - Kim, Hae Won

AU - Kim, Jie-Hyun

AU - Lee, Ik Jae

AU - Kim, Jun Won

AU - Lee, Yongchan

AU - Lee, Chang Geol

AU - Park, Jae Jun

AU - Youn, Young Hoon

AU - Park, HyoJin

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background/Aim: Little is known about the patterns of treatment failure following definitive chemoradiotherapy (CCRT), especially in esophageal squamous cell carcinoma (SCC). We evaluated definitive CCRT failure patterns and determined the predictive factors for treatment response in esophageal SCC. Methods: We evaluated 136 consecutive patients with esophageal SCC treated with definitive CCRT. We evaluated the factors associated with complete remission (CR) after CCRT and analyzed the pattern of treatment failure of recurred patients and incomplete remission patients. The failures were categorized as either within (locoregional failure) or outside the radiation field (out-field failure). Results: Fifty-seven patients achieved CR after CCRT. Consolidation chemotherapy was significantly associated with CR. Only 4 (7.0%) patients had CR after CCRT in patients with M1a node (Celiac or subclavian lymph nodes involvement by 6th AJCC). During follow-up, 74 patients (54.4%) experienced locoregional failure, 26 (19.1%) out-field failure, and 35 (25.7%) no failure. Esophageal obstruction prior to CCRT, residual tumor according to the first follow-up endoscopy, and poor follow-up computed tomography responses were significantly associated with locoregional failure. Conclusion: Approximately 70% of treatment failures were local failures. Future therapeutic strategies need to focus on improving local control to increase treatment outcomes of CCRT.

AB - Background/Aim: Little is known about the patterns of treatment failure following definitive chemoradiotherapy (CCRT), especially in esophageal squamous cell carcinoma (SCC). We evaluated definitive CCRT failure patterns and determined the predictive factors for treatment response in esophageal SCC. Methods: We evaluated 136 consecutive patients with esophageal SCC treated with definitive CCRT. We evaluated the factors associated with complete remission (CR) after CCRT and analyzed the pattern of treatment failure of recurred patients and incomplete remission patients. The failures were categorized as either within (locoregional failure) or outside the radiation field (out-field failure). Results: Fifty-seven patients achieved CR after CCRT. Consolidation chemotherapy was significantly associated with CR. Only 4 (7.0%) patients had CR after CCRT in patients with M1a node (Celiac or subclavian lymph nodes involvement by 6th AJCC). During follow-up, 74 patients (54.4%) experienced locoregional failure, 26 (19.1%) out-field failure, and 35 (25.7%) no failure. Esophageal obstruction prior to CCRT, residual tumor according to the first follow-up endoscopy, and poor follow-up computed tomography responses were significantly associated with locoregional failure. Conclusion: Approximately 70% of treatment failures were local failures. Future therapeutic strategies need to focus on improving local control to increase treatment outcomes of CCRT.

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