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Concurrent Selective Lymph Node Radiotherapy and S-1 Plus Cisplatin for Esophageal Squamous Cell Carcinoma: A Phase II Study

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The efficacy, toxicity, and patterns of failure of esophageal squamous cell carcinoma (ESCC) treated with selective lymph node (SLN) conventional fraction radiotherapy (CFRT) and S-1 plus cisplatin (CDDP) were evaluated.

Patients and Methods

67 Patients with clinical stage II–IVa ESCC were enrolled. The total dose of SLN CFRT was 60 Gy in 30 fractions over 6 weeks. The first course of radiation covered the primary and metastatic regional tumors and high-risk lymph nodal regions, given at 2 Gy/fraction for a dose of 40 Gy. In the second course, CFRT was delivered to the boost volume for an additional 20 Gy in 10 days, using 2 Gy/fraction. Two cycles of chemotherapy were given at the beginning of radiotherapy. CDDP at 25 mg/m2/day was given on days 1–3 and days 22–24, and S-1 at 80 mg/m2/day on days 1–14 and days 22–35. Patients achieving objective response after concurrent chemoradiotherapy underwent two additional cycles of chemotherapy.

Results

The objective response rate (ORR) was 82.5%. Grade 3 or 4 toxicities included leukopenia (23.8%), neutropenia (14.3%), thrombocytopenia (14.3%), hemoglobin (4.8%), gastrointestinal (12.7%), skin (1.6%), and esophagus fistula (1.6%). One patient died of severe pneumonia, and two died of late toxicity because of esophagus fistula. With median follow-up of 32 months, the overall survival (OS) and progression-free survival (PFS) at 1 year and 2 years were 81.0% and 73.0%, and 63.5% and 49.2%, respectively.

Conclusions

SLN RT concurrent with S-1 plus CDDP may represent a better strategy for treatment of ESCC patients.

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Acknowledgement

This study was supported by grants from the Key Scientific and Technological Innovation Project of Shandong Province, China (No. 2017CXZC1206), National Natural Science Foundation of China (No. 81874224), National Natural Science Foundation of China (No. 81773232), and the National Key Research and Development Projects of China (No. 2016YFC0904700).

Author information

Author notes

  1. Xintong Wang and Xiaomeng Liu contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong University, Jinan, Shandong Province, People’s Republic of China

    Xintong Wang PhD, Xiaomeng Liu PhD, Wei Huang PhD & Baosheng Li PhD, MD

  2. School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, China

    Xiaomeng Liu PhD

  3. Department of Thoracic Surgery, JiMo People’s Hospital, Qingdao, China

    Dakun Li BS

  4. Department of Gastroenterology, Qingdao Hiser Medical Center, Qingdao, China

    Xinlei Wang MSc

Authors
  1. Xintong Wang PhD
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  2. Xiaomeng Liu PhD
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  4. Xinlei Wang MSc
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  5. Wei Huang PhD
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  6. Baosheng Li PhD, MD
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Correspondence to Baosheng Li PhD, MD.

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Wang, X., Liu, X., Li, D. et al. Concurrent Selective Lymph Node Radiotherapy and S-1 Plus Cisplatin for Esophageal Squamous Cell Carcinoma: A Phase II Study. Ann Surg Oncol 26, 1886–1892 (2019). https://doi.org/10.1245/s10434-019-07264-4

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  • DOI: https://doi.org/10.1245/s10434-019-07264-4

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