Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2014 Jan 31:14:56.
doi: 10.1186/1471-2407-14-56.

Acute toxicity of definitive chemoradiation in patients with inoperable or irresectable esophageal carcinoma

Nadia Haj Mohammad  1 , Maarten C C M Hulshof, Jacques J G H M Bergman, Debby Geijsen, Johanna W Wilmink, Mark I van Berge Henegouwen, Hanneke W M van Laarhoven
Affiliations
Comparative Study

Acute toxicity of definitive chemoradiation in patients with inoperable or irresectable esophageal carcinoma

Nadia Haj Mohammad et al. BMC Cancer. .

Abstract

Background: Definitive chemoradiation (dCRT) is considered curative intent treatment for patients with inoperable or irresectable esophageal cancer. Acute toxicity data focussing on dCRT are lacking.

Methods: A retrospective analysis of patients treated with dCRT consisting of 6 cycles of paclitaxel 50 mg/m2 and carboplatin AUC2 concomitant with radiotherapy (50.4 Gy\1.8Gy) from 2006 through 2011 at a single tertiary center was performed. Toxicity, hospital admissions and survival were analysed.

Results: 127 patients were treated with definitive chemoradiation. 33 patients were medically inoperable, 94 patients were irresectable, Despite of a significantly smaller tumor length in inoperable patients grade ≥3 toxicity was significantly recorded more often in the inoperable patients (44%) than in irresectable patients (20%) (p < 0.05) Hospital admission occurred more often in the inoperable patients (39%) than in the irresectable patients (22%) (p < 0.05) Median number of cycles of chemotherapy was five for inoperable patients (p = 0.01), while six cycles could be administered to patients with irresectable disease. Recurrence and survival were not significantly different. The odds ratio for developing toxicity ≥ grade 3 was 2.6 (95% CI 1.0-6.4 p < 0.05) for being an inoperable patient and 1.2 (95% CI 1.0-1.4 p = 0.02) per 10 extra micromol/l creatinine.

Conclusions: Our data show that acute toxicity of definitive chemoradiation is worse in patients with medically inoperable esophageal carcinoma compared to patients with irresectable esophageal cancer and mainly occurs in the 5th cycle of treatment. Improvement of supportive care should be undertaken in this more fragile group.

PubMed Disclaimer

References

    1. Ferlay J, Parkin DM, Steliarova-Foucher E. Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer. 2010;46:765–781. doi: 10.1016/j.ejca.2009.12.014. - DOI - PubMed
    1. Gebski V, Burmeister B, Smithers BM. et al.Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol. 2007;8:226–234. doi: 10.1016/S1470-2045(07)70039-6. - DOI - PubMed
    1. van Hagen P, Hulshof MC, van Lanschot JJ. et al.Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366:2074–2084. doi: 10.1056/NEJMoa1112088. - DOI - PubMed
    1. Chak A, Canto M, Gerdes H. et al.Prognosis of esophageal cancers preoperatively staged to be locally invasive (T4) by endoscopic ultrasound (EUS): a multicenter retrospective cohort study. Gastrointest Endosc. 1995;42:501–506. doi: 10.1016/S0016-5107(95)70001-3. - DOI - PubMed
    1. Fockens P, Kisman K, Merkus MP. et al.The prognosis of esophageal carcinoma staged irresectable (T4) by endosonography. J Am Coll Surg. 1998;186:17–23. doi: 10.1016/S1072-7515(97)00131-2. - DOI - PubMed

Publication types

MeSH terms