Clinical outcome of Radical Chemoradiation in Squamous cell carcinoma of the Esophagus
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 4
Abstract
Aim & Objective: Radical chemoradiation is one of the options for curative treatment of carcinoma of the esophagus. This study reports the institutional experience with radical chemoradiation in patients with squamous cell carcinoma of the esophagus Patients & Methods: Patients with non-metastatic squamous cell carcinoma of the esophagus registered between 2013 and 2015 at the hospital were evaluated for retrospective study. The patients were treated with radiation doses of 50-60 Gy by conformal techniques and concurrent platinum, 5-fluorouracil based chemotherapy. Results: Sixty nine patients were found eligible for the study. The mean age was 60 years and had 76.8% males. Thirty six (52.2%) patients had cT4 disease, and 26 (37.7%) had cN+ disease. All patients received radical radiotherapy, while 90% received chemotherapy. Twenty eight (40.6%) patients developed recurrence, with primary site being the most common site of failure. The median time to recurrence was 17months (range: 0-40months). The median overall survival was 43 months and disease free survival was 40 months. The 2 and 3 year overall survival was 72.6% and 54.4% and disease free survival was 62% and 53.8% respectively. Conclusion: Radical chemoradiation for squamous cell carcinoma of esophagus is feasible in the real-life setting and provides a good 3 year overall survival of 54%. More accurate staging of disease with endoscopic ultrasound and PET-CT, more sophisticated radiation with potential to reduce organ toxicity and dose-escalation, and reliable assessment of response to treatment with PET-CT and endoscopic ultrasound with early salvage treatment has the potential to improve these survival figures.
Authors and Affiliations
Dr Arun Sankar Sudha MD
Keywords
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